1902059900 NPI number — MISS JOYE MYREA PASCALL

Table of content: MISS JOYE MYREA PASCALL (NPI 1902059900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902059900 NPI number — MISS JOYE MYREA PASCALL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASCALL
Provider First Name:
JOYE
Provider Middle Name:
MYREA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PASCALL
Provider Other First Name:
JOYE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA/LLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1902059900
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21700 GREENFIELD RD
Provider Second Line Business Mailing Address:
STE 253
Provider Business Mailing Address City Name:
OAK PARK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48237-2581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-968-2600
Provider Business Mailing Address Fax Number:
248-968-2626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21700 GREENFIELD RD
Provider Second Line Business Practice Location Address:
STE 253
Provider Business Practice Location Address City Name:
OAK PARK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48237-2581
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-968-2600
Provider Business Practice Location Address Fax Number:
248-968-2626
Provider Enumeration Date:
11/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  6401008350 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4784339 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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