Provider Demographics
NPI:1578629622
Name:PASAKARNIS, DONALD L (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:PASAKARNIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 TARKILN HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-6355
Mailing Address - Country:US
Mailing Address - Phone:508-998-2020
Mailing Address - Fax:508-998-2047
Practice Address - Street 1:116 TARKILN HILL RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-6355
Practice Address - Country:US
Practice Address - Phone:508-998-2020
Practice Address - Fax:508-998-2047
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA201458Medicare ID - Type Unspecified
MA409558Medicare ID - Type Unspecified
MA0506470001Medicare NSC