Provider Demographics
NPI:1639205446
Name:FLETCHER, STARNIPHA (RPAC)
Entity Type:Individual
Prefix:MRS
First Name:STARNIPHA
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-699-7200
Practice Address - Fax:914-699-0837
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090881363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant