Provider Demographics
NPI:1942200589
Name:PASQUA, GREGORI S (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORI
Middle Name:S
Last Name:PASQUA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-5701
Mailing Address - Country:US
Mailing Address - Phone:718-654-2594
Mailing Address - Fax:718-654-4753
Practice Address - Street 1:3350 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-5701
Practice Address - Country:US
Practice Address - Phone:718-654-2594
Practice Address - Fax:718-654-4753
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX12831Medicare PIN