Provider Demographics
NPI:1164409272
Name:PASCAL, PETER EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:EVAN
Last Name:PASCAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3628
Mailing Address - Country:US
Mailing Address - Phone:413-568-4637
Mailing Address - Fax:413-572-6011
Practice Address - Street 1:115 W SILVER ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3628
Practice Address - Country:US
Practice Address - Phone:413-568-4637
Practice Address - Fax:413-572-6011
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029032207X00000X
NH12141207X00000X
MA76028207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001290329Medicaid
NH30204008Medicaid
MAA3360503OtherMEDICARE
VT1010199Medicaid
NH30204008Medicaid
A63069Medicare UPIN
NHRE7484Medicare ID - Type Unspecified