Provider Demographics
NPI:1295013084
Name:PASCAL, EDLYNE
Entity Type:Individual
Prefix:
First Name:EDLYNE
Middle Name:
Last Name:PASCAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14155 85TH RD
Mailing Address - Street 2:APT 3D
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2553
Mailing Address - Country:US
Mailing Address - Phone:347-481-0607
Mailing Address - Fax:
Practice Address - Street 1:14155 85TH RD
Practice Address - Street 2:APT 3D
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-2553
Practice Address - Country:US
Practice Address - Phone:347-481-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303906164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse