Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA07657600 | NJ |
NPI | 1093761546 |
---|---|
Provider Name | Philip L Pasternak |
First Address | East Brunswick, NJ 08816-0067 |
Second Address | Lakewood, NJ 08701-2069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 22/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H70986 | (02) |