MEDICARE: MARIA I PASNICIUC MD

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	207RR0500X	Rheumatology Physician	263096-1	NY

General Provider Information

NPI Number	:	1831192806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA I PASNICIUC MD

Provider Business Mailing Address
First Line	:	5794 WIDEWATERS PKWY
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13214-1845
Country	:	US
Telephone Number	:	315-422-1513
Fax Number	:	315-422-5890

Provider Business Practice Location Address
First Line	:	5794 WIDEWATERS PKWY
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13214
Country	:	US
Telephone Number	:	315-422-1513
Fax Number	:	315-422-5890

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/10/2020

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