MEDICARE: DR. PAUL C GIASI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	229364	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000156065	OTHER	NY	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457318602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL C GIASI MD

Provider Business Mailing Address
First Line	:	5831 MIRALAGO LN
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8664
Country	:	US
Telephone Number	:	315-727-0741
Fax Number	:

Provider Business Practice Location Address
First Line	:	5831 MIRALAGO LN
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8664
Country	:	US
Telephone Number	:	315-727-0741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	01/28/2013

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