Provider Demographics
NPI:1730179755
Name:NASTEVSKI, VASE (BS/MS PT)
Entity type:Individual
Prefix:
First Name:VASE
Middle Name:
Last Name:NASTEVSKI
Suffix:
Gender:F
Credentials:BS/MS PT
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Other - First Name:
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Mailing Address - Street 1:1291 INDIAN CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2003
Mailing Address - Country:US
Mailing Address - Phone:716-390-4516
Mailing Address - Fax:
Practice Address - Street 1:101 OAK ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-2215
Practice Address - Country:US
Practice Address - Phone:716-856-4202
Practice Address - Fax:716-332-3570
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2012-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY027203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000628898001OtherCOM. BLUE , BC/BS
NY00639487Medicaid