Healthcare Provider Details

I. General information

NPI: 1821026501
Provider Name (Legal Business Name): PAUL EDWARD ESACHINA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WASHINGTON RD CREDENTIAL'S OFFICE, KELLER ARMY COMMUNITY HOSPITAL
WEST POINT NY
10996-1197
US

IV. Provider business mailing address

107 W DEVINNEY HOLLOW RD
BLAIRSVILLE PA
15717-7652
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-3470
  • Fax:
Mailing address:
  • Phone: 724-248-7283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN266640L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: