Provider Demographics
NPI:1942404025
Name:STAPLE, DEBORAH LEE (RPAC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEE
Last Name:STAPLE
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:STAPLE
Other - Last Name:ABEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPAC
Mailing Address - Street 1:421 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421
Mailing Address - Country:US
Mailing Address - Phone:315-363-2350
Mailing Address - Fax:315-361-1827
Practice Address - Street 1:90 TABERG ROAD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NY
Practice Address - Zip Code:13316
Practice Address - Country:US
Practice Address - Phone:315-245-5483
Practice Address - Fax:315-245-5482
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0030931208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics