MEDICARE: RODOLFO PASCUAL M.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	208600000X	Surgery Physician	25MA02621500	NJ

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	:	1407857824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODOLFO PASCUAL M.D.

Provider Business Mailing Address
First Line	:	131 MADISON AVE
Second Line	:
City	:	MOUNT HOLLY
State	:	NJ
Zip	:	08060-2043
Country	:	US
Telephone Number	:	609-267-7050
Fax Number	:	609-267-9653

Provider Business Practice Location Address
First Line	:	131 MADISON AVE
Second Line	:
City	:	MOUNT HOLLY
State	:	NJ
Zip	:	08060-2043
Country	:	US
Telephone Number	:	609-267-7050
Fax Number	:	609-267-9653

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/25/2009

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