Provider Demographics
NPI:1598873952
Name:PASHCOW, MELISSA SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUSAN
Last Name:PASHCOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 2ND AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3313
Mailing Address - Country:US
Mailing Address - Phone:212-737-0220
Mailing Address - Fax:718-497-8762
Practice Address - Street 1:1430 2ND AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3313
Practice Address - Country:US
Practice Address - Phone:212-737-0220
Practice Address - Fax:718-497-8762
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131048207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00524832Medicaid
NY41407OtherGHI MEDICARE
NY35A531Medicare ID - Type Unspecified
NY00524832Medicaid