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General NPI Number Information
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NPI Number | 1043324403
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Entity Type | Individual
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Provider Name | JANICE P PASTUSZAK NP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 421 N. MAIN STREET
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City | LEEDS
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State | MA
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Zip | 01053
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Country | US
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Telephone | 413-584-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 PARKER STREET
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City | SPRINGFIELD
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State | MA
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Zip | 01129-1004
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Country | US
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Telephone | 413-782-2990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 98655
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License Number State | MA
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