Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS009694L | PA |
NPI | 1215995717 |
---|---|
Provider Name | David Pasquale |
First Address | Wexford, PA 15090-8685 |
Second Address | Pittsburgh, PA 15213-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A15516 | (02) |