Paulo Espanola
Individual provider Active NPI Psychiatry Physician · Marcy, NY
NPI 1003018698 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003018698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 237091 (NY)
- Practice address
- 300 Wright Avenue
Marcy, NY 13404 - Phone
- (315) 736-8271
- NPI assigned
- Jun 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237091 | NY | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 237091 | NY | Yes |
Addresses
Primary practice location
300 Wright Avenue
Marcy, NY 13404
Mailing address
243 Lord Byron LN
Williamsville, NY 14221-1999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 237091 | Medicaid | NY |
Other providers in Marcy, NY
- Paul Daugherty
- Nicole Marie Debernardis
- Dawn Delmonte
- Danielle Dill
- Randy Allen Dymond
- Wendy Lyn Everleth
- Lawrence Farago
- Amy Ferguson
- Carrie Lynn George
- Cynthia Jean Grabski
All providers in Marcy, NY · Psychiatry Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.