Healthcare Provider Details

I. General information

NPI: 1528541869
Provider Name (Legal Business Name): LEXANDRIA PASCARELLA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 INTERSTATE PKWY STE 41
BRADFORD PA
16701-1036
US

IV. Provider business mailing address

116 INTERSTATE PKWY STE 41
BRADFORD PA
16701-1036
US

V. Phone/Fax

Practice location:
  • Phone: 814-363-9484
  • Fax:
Mailing address:
  • Phone: 814-363-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number022511
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA062423
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: