Provider Demographics
NPI:1447588520
Name:ROBERT S. PASTAN, MD
Entity Type:Organization
Organization Name:ROBERT S. PASTAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBET
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:PASTAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-662-7477
Mailing Address - Street 1:3 WOODLAND RD
Mailing Address - Street 2:SUITE 413
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1702
Mailing Address - Country:US
Mailing Address - Phone:781-662-7477
Mailing Address - Fax:781-662-0805
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 413
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-662-7477
Practice Address - Fax:781-662-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty