MEDICARE: DR. ALVARO PASCUAL-LEONE M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0600X	Clinical Neurophysiology Physician	152632	MA
2	2084N0400X	Neurology Physician	152632	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073591228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALVARO PASCUAL-LEONE M.D., PH.D.

Provider Business Mailing Address
First Line	:	375 LONGWOOD AVE
Second Line	:	HARVARD MEDICAL FACULTY ASSOCIATES - MASCO BUILDING
City	:	BOSTON
State	:	MA
Zip	:	02215-5395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 CENTRE ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-1000
Country	:	US
Telephone Number	:	617-363-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	08/28/2019

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