Provider Demographics
NPI:1407377294
Name:PASQUALE, TANYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:PASQUALE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BERRYBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6640
Mailing Address - Country:US
Mailing Address - Phone:201-783-6542
Mailing Address - Fax:
Practice Address - Street 1:2323 NW MAYNARD RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8826
Practice Address - Country:US
Practice Address - Phone:919-462-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist