Provider Demographics
NPI:1093222440
Name:MILASK, PAMELA BETH (L OM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:BETH
Last Name:MILASK
Suffix:
Gender:F
Credentials:L OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 OLD YORK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2013
Mailing Address - Country:US
Mailing Address - Phone:215-858-7554
Mailing Address - Fax:215-659-2715
Practice Address - Street 1:1250 OLD YORK RD STE 102
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2013
Practice Address - Country:US
Practice Address - Phone:215-858-7554
Practice Address - Fax:215-659-2715
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM000062171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist