Healthcare Provider Details

I. General information

NPI: 1316993603
Provider Name (Legal Business Name): JOSEPH D NASCA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789B ETHAN ALLEN HWY
MILTON VT
05468-9797
US

IV. Provider business mailing address

PO BOX 2049
MILTON VT
05468-2049
US

V. Phone/Fax

Practice location:
  • Phone: 802-527-2237
  • Fax: 802-527-2267
Mailing address:
  • Phone: 802-527-2237
  • Fax: 802-527-2267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0420008333
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: