Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 25MA10208200 | NJ |
N | 207RH0002X | Hospice and Palliative Medicine | MD459333 | PA |
NPI | 1366754517 |
---|---|
Provider Name | Dr. Keith Philip Pasichow |
First Address | Philadelphia, PA 19128-5022 |
Second Address | Shrewsbury, NJ 07702-9908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2010 |
Last Update Date | 07/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04301277 | (05) | NY |
0682136 | (05) | NJ |
1035864390001 | (05) | PA |