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General NPI Number Information
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NPI Number | 1699774620
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Entity Type | Individual
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Provider Name | WARREN A PASTERNACK D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | B2 BRIER HILL CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3348
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Country | US
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Telephone | 732-254-9302
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Fax | 732-613-4758
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Provider Business Mailing Address
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Address Line | 3 JASON DR
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City | E BRUNSWICK
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State | NJ
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Zip | 08816-3342
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Country | US
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Telephone | 732-254-1007
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00116600
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License Number State | NJ
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