Provider Demographics
NPI:1821026501
Name:ESACHINA, PAUL EDWARD (CRNA)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:ESACHINA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W DEVINNEY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-7652
Mailing Address - Country:US
Mailing Address - Phone:724-248-7283
Mailing Address - Fax:
Practice Address - Street 1:900 WASHINGTON RD
Practice Address - Street 2:CREDENTIAL'S OFFICE, KELLER ARMY COMMUNITY HOSPITAL
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1197
Practice Address - Country:US
Practice Address - Phone:845-938-3470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN266640L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
33025FMedicare ID - Type Unspecified
VAD000Medicare UPIN