Provider Demographics
NPI:1790007482
Name:PAPA, LAUREN M (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:M
Last Name:PAPA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 MAPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9618
Mailing Address - Country:US
Mailing Address - Phone:518-732-4189
Mailing Address - Fax:
Practice Address - Street 1:23 FISH AND GAME RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3815
Practice Address - Country:US
Practice Address - Phone:518-828-8704
Practice Address - Fax:518-828-8772
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031661-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist