Healthcare Provider Details

I. General information

NPI: 1396651949
Provider Name (Legal Business Name): ANASTASYA MARIE PAVLOSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 THIMBLE SHOALS BLVD # C
NEWPORT NEWS VA
23606-2574
US

IV. Provider business mailing address

4 BRICK MILL CIR
MIDDLETOWN DE
19709-7930
US

V. Phone/Fax

Practice location:
  • Phone: 757-455-5000
  • Fax:
Mailing address:
  • Phone: 304-996-3235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: