MEDICARE: DR. JOHN ANTHONY PASQUELLA D.O.

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	207X00000X	Orthopaedic Surgery Physician	OS013958	PA

General Provider Information

NPI Number	:	1699920926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ANTHONY PASQUELLA D.O.

Provider Business Mailing Address
First Line	:	2435 HILLOCK CT
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-4320
Country	:	US
Telephone Number	:	215-353-2142
Fax Number	:

Provider Business Practice Location Address
First Line	:	4170 CITY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1610
Country	:	US
Telephone Number	:	215-871-6100
Fax Number	:

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

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	12/01/2008

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