Provider Demographics
NPI:1447341128
Name:POSPIECH, EDWARD FELIX (PA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:FELIX
Last Name:POSPIECH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3452 STATE ROUTE 31
Mailing Address - Street 2:BALDWINSVILLE FAMILY MEDICAL CARE
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9231
Mailing Address - Country:US
Mailing Address - Phone:315-652-1325
Mailing Address - Fax:315-652-1972
Practice Address - Street 1:3452 STATE ROUTE 31
Practice Address - Street 2:BALDWINSVILLE FAMILY MEDICAL CARE
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-9231
Practice Address - Country:US
Practice Address - Phone:315-652-1325
Practice Address - Fax:315-652-1972
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0003161363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS63364Medicare UPIN
NYP00355017Medicare PIN
NYPA1359Medicare PIN
NY02160745Medicare PIN