Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 011852-1 | NY |
NPI | 1174582472 |
---|---|
Provider Name | Paul C Nation |
First Address | Batavia, NY 14020-1613 |
Second Address | Batavia, NY 14020-1613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 01/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000524520001 | BLUE CROSS WNY (01) | NY |
01501817 | (05) | NY |
MDE421 | PREFERRED CARE (01) | NY |
P01001852 | BLUE CHOICE (01) | NY |