Healthcare Provider Details

I. General information

NPI: 1639192677
Provider Name (Legal Business Name): PAUL C NASCA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2562 WALDEN AVE SUITE 105
CHEEKTOWAGA NY
14225-4758
US

IV. Provider business mailing address

5 CREEKVIEW CT
EAST AURORA NY
14052-2181
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-3330
  • Fax: 716-683-7759
Mailing address:
  • Phone: 716-390-2173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN0036331
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: