Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 227125 | NY |
Y | 111NI0900X | Internist | 227125 | NY |
N | 207RC0200X | Critical Care Medicine | 227125 | NY |
NPI | 1003975616 |
---|---|
Provider Name | Dr. Annalisa Pastore |
First Address | Englewood, NJ 07631-6583 |
Second Address | Englewood, NJ 07631-6583 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 21/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02693332 | (05) | NY |
I45387 | (02) | NY |