Provider Demographics
NPI:1578773388
Name:PAPPAS, PARIS MICHELE (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:PARIS
Middle Name:MICHELE
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MRS
Other - First Name:PARIS
Other - Middle Name:MICHELE
Other - Last Name:BAURIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:27 CAMEL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LLOYD HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1604
Mailing Address - Country:US
Mailing Address - Phone:631-424-0226
Mailing Address - Fax:
Practice Address - Street 1:27 CAMEL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LLOYD HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11743-1604
Practice Address - Country:US
Practice Address - Phone:631-424-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006983363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant