Healthcare Provider Details

I. General information

NPI: 1164490587
Provider Name (Legal Business Name): BARBARA ANN PASCAL-GLADSTONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HAYNES STREET
MANCHESTER CT
06040
US

IV. Provider business mailing address

17 HICKORY HL
VERNON CT
06066-5833
US

V. Phone/Fax

Practice location:
  • Phone: 860-646-1222
  • Fax: 860-533-3452
Mailing address:
  • Phone: 860-872-3297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number001514
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: