Provider Demographics
NPI:1316993603
Name:NASCA, JOSEPH D (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:NASCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2049
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-2049
Mailing Address - Country:US
Mailing Address - Phone:802-527-2237
Mailing Address - Fax:802-527-2267
Practice Address - Street 1:789B ETHAN ALLEN HWY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-9797
Practice Address - Country:US
Practice Address - Phone:802-527-2237
Practice Address - Fax:802-527-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420008333208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1003400Medicaid
VT18116Medicare ID - Type Unspecified
F78749Medicare UPIN