Healthcare Provider Details

I. General information

NPI: 1194793752
Provider Name (Legal Business Name): ROBERT C PASCUCCI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

9 LIVINGSTON RD
WELLESLEY MA
02482-7307
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-7327
  • Fax:
Mailing address:
  • Phone: 781-237-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number46178
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number46178
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: