Provider Demographics
NPI:1861617839
Name:TRAPP, JOSEPH (RPA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:TRAPP
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-0304
Mailing Address - Country:US
Mailing Address - Phone:518-926-1935
Mailing Address - Fax:518-926-4804
Practice Address - Street 1:135 NORTH RD
Practice Address - Street 2:WILTON FAMILY MEDICINE
Practice Address - City:WILTON
Practice Address - State:NY
Practice Address - Zip Code:12831-1308
Practice Address - Country:US
Practice Address - Phone:518-926-1965
Practice Address - Fax:518-926-4804
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003080363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02347708Medicaid
NYP00687642OtherRR MEDICARE
NY02347708Medicaid
NYJ400000520Medicare PIN