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NPI Code Detail

MEDICARE: PASKO L GAZIVODA DPM

MEDICARE:   PASKO L GAZIVODA  DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist25MD00175700NJ

General Provider Information

NPI Number : 1518908474
Entity Type Code : Individual
Provider Name (Legal Business Name) : PASKO L GAZIVODA DPM
Provider Business Mailing Address
First Line : 67 BROADWAY
Second Line :
City : ELMWOOD PARK
State : NJ
Zip : 07407-1836
Country : US
Telephone Number : 201-794-3223
Fax Number : 201-794-8411
Provider Business Practice Location Address
First Line : 67 BROADWAY
Second Line :
City : ELMWOOD PARK
State : NJ
Zip : 07407-1836
Country : US
Telephone Number : 201-794-3223
Fax Number : 201-794-8411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/08/2007

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Directions to “ PASKO L GAZIVODA DPM” Practice Location

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