Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F400624 | NY |
NPI | 1033114574 |
---|---|
Provider Name | Ann Marie Pasek |
First Address | Alden, NY 14004-9454 |
Second Address | Alden, NY 14004-9454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 19/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000560709004 | BCBS OF WNY (01) | NY |
000560709005 | BCBS OF WNY (01) | NY |
9590016 | INDEPENDENT HEALTH (01) | NY |
J300000059 | MEDICARE PTAN (01) | NY |