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General NPI Number Information
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NPI Number | 1659626331
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Entity Type | Individual
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Provider Name | ILANA T PASTERNAK MSED
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 3321 AVENUE M
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City | BROOKLYN
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State | NY
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Zip | 11210-5421
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Country | US
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Telephone | 718-531-1800
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Fax | 718-407-2648
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Provider Business Mailing Address
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Address Line | 2301 KINGS HWY 2J
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City | BROOKLYN
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State | NY
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Zip | 11229-1671
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Country | US
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Telephone | 718-564-0175
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Fax | 718-407-2648
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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