Individual
MR. PAUL D DAMICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Mailing address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
469255-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000496079001
BLUE SHIELD NENY
—
01
—
10002421
CDPHP
—
01
—
4123058
MVP
—
01
—
469255-1
TRICARE NORTH REGION
—
01
—
9704569
GHI
—
01
—
BB6650
FIDELIS MEDICARE
—
01
—
R6B52
EMPIRE BLUE CROSS
—
01
—
X00000
AMERICAN PROGRESSIVE TODA
—
Enumeration date
08/09/2005
Last updated
11/10/2010
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