KEVIN C LAKE

SYRACUSE, NY
NPI1841253341
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: NY  010298)
Enumeration Date2006-04-07
Last Update Date2009-06-18
Business Address
KEVIN C LAKE RPA
475 IRVING AVE SUITE 418
SYRACUSE, NY 13210-1756
Phone number: 315-426-0190
Mailing Address
KEVIN C LAKE RPA
475 IRVING AVE SUITE 418
SYRACUSE, NY 13210-1756
Phone number: 315-426-0190