Provider Demographics
NPI:1922064815
Name:OKEEFE, LEA M (PA)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:M
Last Name:OKEEFE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LEA
Other - Middle Name:M
Other - Last Name:RIPEPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5200 CENTRE AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1300
Mailing Address - Country:US
Mailing Address - Phone:412-621-7777
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1300
Practice Address - Country:US
Practice Address - Phone:412-621-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051185363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP94334Medicare UPIN