Provider Demographics
NPI:1497757918
Name:PACANA, DAVID JAMES (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:PACANA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-7021
Mailing Address - Country:US
Mailing Address - Phone:716-692-0021
Mailing Address - Fax:716-692-2321
Practice Address - Street 1:424 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-7021
Practice Address - Country:US
Practice Address - Phone:716-692-0021
Practice Address - Fax:716-692-2321
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2008-06-30
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-05-03
Provider Licenses
StateLicense IDTaxonomies
NYX009343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU74822Medicare UPIN
NYBA0899Medicare PIN
NYP00477750Medicare PIN