Provider Demographics
NPI:1346766292
Name:PASQUALE, SCOTT ADAM (NP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ADAM
Last Name:PASQUALE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331R HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1738
Mailing Address - Country:US
Mailing Address - Phone:978-744-3499
Mailing Address - Fax:978-744-6576
Practice Address - Street 1:331R HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1738
Practice Address - Country:US
Practice Address - Phone:978-744-3499
Practice Address - Fax:978-744-6576
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2273752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily