Provider Demographics
NPI:1952482143
Name:PASQUALE, SALVATORE J (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:J
Last Name:PASQUALE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-271-9712
Practice Address - Street 1:35 S RIVERSIDE AVE
Practice Address - Street 2:MOUNT KISCO MEDICLA GROUP, PC
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2653
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-271-9712
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-07-05
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Provider Licenses
StateLicense IDTaxonomies
NY189735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01464662Medicaid
NY01464662Medicaid