Provider Demographics
NPI:1033240999
Name:PASCASCIO, ATHERA MOSS (MA)
Entity Type:Individual
Prefix:
First Name:ATHERA
Middle Name:MOSS
Last Name:PASCASCIO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 S SABLE CIR
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5653
Mailing Address - Country:US
Mailing Address - Phone:954-978-0868
Mailing Address - Fax:
Practice Address - Street 1:2677 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3340
Practice Address - Country:US
Practice Address - Phone:954-739-8066
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator