Provider Demographics
NPI:1447506951
Name:PASKO, KRISTY M
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:M
Last Name:PASKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 DELAWARE AVE
Mailing Address - Street 2:APT 605
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2212
Mailing Address - Country:US
Mailing Address - Phone:716-912-3387
Mailing Address - Fax:
Practice Address - Street 1:5205 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-9618
Practice Address - Country:US
Practice Address - Phone:716-625-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist