Healthcare Provider Details

I. General information

NPI: 1417690710
Provider Name (Legal Business Name): THARICK PASCOAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 5TH AVE STE 810
PITTSBURGH PA
15213-3206
US

IV. Provider business mailing address

200 MEYRAN AVE RM 507
PITTSBURGH PA
15213-3305
US

V. Phone/Fax

Practice location:
  • Phone: 412-663-6628
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberMD483362
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: