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General NPI Number Information
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NPI Number | 1700917952
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Entity Type | Individual
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Provider Name | JAY KRIS PASCUAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 10 WILDWOOD MEDICAL CTR
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City | ESSEX
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State | CT
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Zip | 06426-1154
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Country | US
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Telephone | 860-767-0145
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Fax | 860-767-0021
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Provider Business Mailing Address
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Address Line | 7245 52ND AVE APT 1
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City | MASPETH
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State | NY
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Zip | 11378-1571
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Country | US
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Telephone | 718-527-2068
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 22101
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 207016
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C182362
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 81434
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License Number State | CT
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