Provider Demographics
NPI:1780940296
Name:PAPAY, STEPHEN GENTRY (MAT,ATC, NASM-PES)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GENTRY
Last Name:PAPAY
Suffix:
Gender:M
Credentials:MAT,ATC, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7060 STATE ROUTE 104
Mailing Address - Street 2:LAKER HALL
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-3501
Mailing Address - Country:US
Mailing Address - Phone:315-312-2859
Mailing Address - Fax:
Practice Address - Street 1:7060 STATE ROUTE 104
Practice Address - Street 2:LAKER HALL
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3501
Practice Address - Country:US
Practice Address - Phone:315-312-2859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002566-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer