Provider Demographics
NPI:1437492964
Name:PASICK, CHRISTINA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:PASICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 HIGHWAY 34 BLDG A
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9750
Mailing Address - Country:US
Mailing Address - Phone:732-281-1988
Mailing Address - Fax:
Practice Address - Street 1:1959 HIGHWAY 34 BLDG A
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9750
Practice Address - Country:US
Practice Address - Phone:732-573-6796
Practice Address - Fax:732-281-1988
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10553400208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PANAOtherNA