Provider Demographics
NPI:1043908627
Name:PAZERA, JOSEPH A (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:PAZERA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2617
Mailing Address - Country:US
Mailing Address - Phone:417-414-8862
Mailing Address - Fax:
Practice Address - Street 1:85 INDUSTRIAL TRACT ANX
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1505
Practice Address - Country:US
Practice Address - Phone:518-828-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007093-01363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical