Healthcare Provider Details

I. General information

NPI: 1194778332
Provider Name (Legal Business Name): BERNARD PASQUARIELLA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 HENRY HUDSON PKWY THE WHITEHALL, SUITE 1D
BRONX NY
10463-3224
US

IV. Provider business mailing address

3333 HENRY HUDSON PKWY THE WHITEHALL, SUITE 1D
BRONX NY
10463-3224
US

V. Phone/Fax

Practice location:
  • Phone: 917-805-3955
  • Fax:
Mailing address:
  • Phone: 917-805-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001623
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: