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NPI Code Detail

MEDICARE: TRISHA VANSLYKE-PASCO NP

MEDICARE: TRISHA VANSLYKE-PASCO NP
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
1163W00000XRegistered Nurse631963NY
2363L00000XNurse Practitioner350120NY

General Provider Information

NPI Number : 1578201919
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISHA VANSLYKE-PASCO NP
Provider Business Mailing Address
First Line : 2209 GENESEE ST
Second Line :
City : UTICA
State : NY
Zip : 13501-5999
Country : US
Telephone Number : 315-801-8534
Fax Number : 315-801-8391
Provider Business Practice Location Address
First Line : 37 MAIN ST
Second Line :
City : WHITESBORO
State : NY
Zip : 13492-1034
Country : US
Telephone Number : 315-624-8800
Fax Number : 315-624-8810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 08/23/2022

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