Raphaelidis, Leia

Raphaelidis, Leia is an individual health care provider with primary practice located at 620 W Seneca St , Ithaca NY 14850-3326. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Raphaelidis, Leia can be contacted via phone (607) 273-1513.

Contact Information

Primary practice address
620 W Seneca St Ithaca NY 14850-3326
Phone: (607) 273-1513
Fax: (607) 273-8776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F333784 New York

Profile Details

NPI number 1790851814
LBN Legal business name Raphaelidis, Leia
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Jun 25th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790851814 NPPES
New York MEDICAID 00362863

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