MEDICARE: VALENTINA MARIE PASQUALE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1124681184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENTINA MARIE PASQUALE

Provider Business Mailing Address
First Line	:	506 SHELDON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2727
Country	:	US
Telephone Number	:	347-466-1952
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 NEW DORP PLZ S
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2966
Country	:	US
Telephone Number	:	347-466-1952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	04/16/2019

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Directions to “ VALENTINA MARIE PASQUALE ” Practice Location

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