Healthcare Provider Details

I. General information

NPI: 1033106406
Provider Name (Legal Business Name): PASQUA DARNELL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NORTH US-23
HARRISVILLE MI
48740
US

IV. Provider business mailing address

300 NORTH US-23
HARRISVILLE MI
48740
US

V. Phone/Fax

Practice location:
  • Phone: 989-724-7440
  • Fax: 989-724-7531
Mailing address:
  • Phone: 989-724-7440
  • Fax: 989-724-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901003963
License Number StateMI

VIII. Authorized Official

Name: MRS. TOMMASINA PASQUA DARNELL
Title or Position: OWNER
Credential: OD
Phone: 989-724-7440