MEDICARE: DORIAN PASCOE MSPT

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	225100000X	Physical Therapist	019031	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30-0510484	OTHER		IRS

General Provider Information

NPI Number	:	1780838854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIAN PASCOE MSPT

Provider Business Mailing Address
First Line	:	51 SARANAC ST
Second Line	:
City	:	DOBBS FERRY
State	:	NY
Zip	:	10522-1123
Country	:	US
Telephone Number	:	646-734-0008
Fax Number	:	914-231-5565

Provider Business Practice Location Address
First Line	:	2735 HENRY HUDSON PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-4701
Country	:	US
Telephone Number	:	646-734-0008
Fax Number	:	914-231-5565

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

Provider Enumeration Date	:	11/15/2008
Last Update Date	:	11/15/2008

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Directions to “ DORIAN PASCOE MSPT” Practice Location

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