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1841253341
KEVIN C LAKE
SYRACUSE, NY
NPI
1841253341
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant Medical
(Licence: NY 010298)
Enumeration Date
2006-04-07
Last Update Date
2009-06-18
Business Address
KEVIN C LAKE RPA
475 IRVING AVE SUITE 418
SYRACUSE, NY 13210-1756
Phone number: 315-426-0190
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Mailing Address
KEVIN C LAKE RPA
475 IRVING AVE SUITE 418
SYRACUSE, NY 13210-1756
Phone number: 315-426-0190
Copy
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