Provider Demographics
NPI:1295090017
Name:CESCHINI, PAUL G
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:CESCHINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1923
Mailing Address - Country:US
Mailing Address - Phone:631-891-7234
Mailing Address - Fax:
Practice Address - Street 1:26 SHARON DR
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1923
Practice Address - Country:US
Practice Address - Phone:631-891-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY881978981174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist