Individual
COLIN J WASACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1044 STATE ST, SCHENECTADY, NY 12307-1508
(518) 370-1441
(518) 395-9431
Mailing address
1044 STATE ST, SCHENECTADY, NY 12307-1508
(518) 370-1441
(518) 395-9431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062612
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02995513
—
NY
01
—
331833
OSCAR
NY
01
—
53099A
MEDICARE PIN
—
Enumeration date
03/20/2021
Last updated
08/16/2022
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