Healthcare Provider Details

I. General information

NPI: 1649445495
Provider Name (Legal Business Name): ELSA D. PASCUAL, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 ROUTE 207
GOSHEN NY
10924-5002
US

IV. Provider business mailing address

3302 ROUTE 207
GOSHEN NY
10924-5002
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-8817
  • Fax: 845-294-3612
Mailing address:
  • Phone: 845-294-8817
  • Fax: 845-294-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number144835
License Number StateNY

VIII. Authorized Official

Name: DR. ELSA D PASCUAL
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 845-294-8817