Provider Demographics
NPI:1174582472
Name:NATION, PAUL C (PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:NATION
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1613
Mailing Address - Country:US
Mailing Address - Phone:585-344-3190
Mailing Address - Fax:585-344-3235
Practice Address - Street 1:203 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1613
Practice Address - Country:US
Practice Address - Phone:585-344-3190
Practice Address - Fax:585-344-3235
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011852-1103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01001852OtherBLUE CHOICE
NYMDE421OtherPREFERRED CARE
NY01501817Medicaid
NY000524520001OtherBLUE CROSS WNY
NY01501817Medicaid