1760642615 NPI number — DR. PASQUALE PATRICK VASCIMINI DDS

Table of content: DR. PASQUALE PATRICK VASCIMINI DDS (NPI 1760642615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760642615 NPI number — DR. PASQUALE PATRICK VASCIMINI DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VASCIMINI
Provider First Name:
PASQUALE
Provider Middle Name:
PATRICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760642615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3010 WESTCHESTER AVE
Provider Second Line Business Mailing Address:
STE 309
Provider Business Mailing Address City Name:
PURCHASE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10577-2502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-251-0636
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 RYE RIDGE PLZ
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
RYE BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10573-2828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-251-0636
Provider Business Practice Location Address Fax Number:
914-251-0642
Provider Enumeration Date:
06/13/2008

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: 122300000X , with the licence number:  041565-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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