Provider Demographics
NPI:1457318602
Name:GIASI, PAUL C (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:GIASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5831 MIRALAGO LN
Mailing Address - Street 2:
Mailing Address - City:BREWERTON
Mailing Address - State:NY
Mailing Address - Zip Code:13029-8664
Mailing Address - Country:US
Mailing Address - Phone:315-727-0741
Mailing Address - Fax:
Practice Address - Street 1:5831 MIRALAGO LN
Practice Address - Street 2:
Practice Address - City:BREWERTON
Practice Address - State:NY
Practice Address - Zip Code:13029-8664
Practice Address - Country:US
Practice Address - Phone:315-727-0741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229364207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000156065OtherBLUE SHIELD
NY02426979Medicaid
NY000156065OtherBLUE SHIELD
NY02426979Medicaid
NYJ400037212Medicare PIN