Provider Demographics
NPI:1639345713
Name:PASIA, ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:PASIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 EAGLE ROCK AVE
Mailing Address - Street 2:STE 154
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3168
Mailing Address - Country:US
Mailing Address - Phone:201-407-5145
Mailing Address - Fax:862-701-6444
Practice Address - Street 1:120 EAGLE ROCK AVE STE 154
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936
Practice Address - Country:US
Practice Address - Phone:201-447-4772
Practice Address - Fax:862-701-6444
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009012502208100000X, 2081P2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00806484OtherRAILROAD MEDICARE