Provider Demographics
NPI:1235491499
Name:PASTORE, KAREN A (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:PASTORE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 GATE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1734
Mailing Address - Country:US
Mailing Address - Phone:516-942-3602
Mailing Address - Fax:
Practice Address - Street 1:93 GATE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1734
Practice Address - Country:US
Practice Address - Phone:516-942-3602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1385102174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1385102OtherNYS SPECIAL EDUCATION CERTIFICATE
NY1-11-8389OtherBOARD CERTIFIED BEHAVIOR ANALYST