Healthcare Provider Details

I. General information

NPI: 1538079470
Provider Name (Legal Business Name): MATHEW ALBERT PASCALL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 HILLCREST LN
WILLINGBORO NJ
08046-1204
US

IV. Provider business mailing address

29 HILLCREST LN
WILLINGBORO NJ
08046-1204
US

V. Phone/Fax

Practice location:
  • Phone: 814-737-7311
  • Fax:
Mailing address:
  • Phone: 814-737-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: