Provider Demographics
NPI:1407088008
Name:IAN PASCH DDS PC
Entity Type:Organization
Organization Name:IAN PASCH DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZHINOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-689-0024
Mailing Address - Street 1:224 W 35TH ST
Mailing Address - Street 2:16TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2507
Mailing Address - Country:US
Mailing Address - Phone:212-689-0024
Mailing Address - Fax:
Practice Address - Street 1:224 W 35TH ST
Practice Address - Street 2:16TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2507
Practice Address - Country:US
Practice Address - Phone:212-689-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036196122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty