MEDICARE: RICHARD A. PASCUCCI DO

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	207R00000X	Internal Medicine Physician	OS003520L	PA
2	207RR0500X	Rheumatology Physician	OS003520L	PA

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	:	1255332367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A. PASCUCCI DO

Provider Business Mailing Address
First Line	:	4190 CITY AVE
Second Line	:	SUITE 330
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6337
Fax Number	:	215-871-6347

Provider Business Practice Location Address
First Line	:	4190 CITY AVE
Second Line	:	SUITE 330
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6337
Fax Number	:	215-871-6347

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	11/24/2009

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Directions to “ RICHARD A. PASCUCCI DO” Practice Location

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