Provider Demographics
NPI:1982995833
Name:TAPE, PAUL D (RN NURSE)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:TAPE
Suffix:
Gender:M
Credentials:RN NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-3207
Mailing Address - Country:US
Mailing Address - Phone:585-615-1422
Mailing Address - Fax:
Practice Address - Street 1:363 BRITTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-3207
Practice Address - Country:US
Practice Address - Phone:585-615-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2487281164W00000X
NY656746163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2487281OtherLPN