Doctor Name: | PAUL C LAFATA |
NPI Number: | 1790785947 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | SC004661-L |
Business Practice Address: | 25 Stevens Ave West Lawn, PA - 196091424 |
Business Phone Number: | 6106784581 |
Business Fax Number: | 6106788677 |
Mailing Address: | 25 Stevens Ave, WEST LAWN |
State: | PA |
Postal Code: | 196091424 |
Phone Number: | 6106784581 |
Fax Number: | 6106788677 |
NPI Enumeration Date: | 07/29/2005 |
NPI Last Update Date: | 01/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC004661-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |