Healthcare Provider Details

I. General information

NPI: 1104082023
Provider Name (Legal Business Name): DENNIS A. PASTENA, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 STONELEIGH AVE SUITE 125
CARMEL NY
10512-2454
US

IV. Provider business mailing address

667 STONELEIGH AVE SUITE 125
CARMEL NY
10512-2454
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-9009
  • Fax: 845-278-9091
Mailing address:
  • Phone: 845-278-9009
  • Fax: 845-278-9091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number121096
License Number StateNY

VIII. Authorized Official

Name: DR. DENNIS ANTHONY PASTENA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-278-9009