Provider Demographics
NPI:1518739523
Name:PAQUIN, CODY (EMT)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:PAQUIN
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-2430
Mailing Address - Country:US
Mailing Address - Phone:151-846-6368
Mailing Address - Fax:
Practice Address - Street 1:85 3RD ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:NY
Practice Address - Zip Code:12188-2430
Practice Address - Country:US
Practice Address - Phone:151-846-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406274146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic