Provider Demographics
NPI:1013056852
Name:PASOS, TRICIA J (DC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:J
Last Name:PASOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:J
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:128 MAIN ST
Mailing Address - Street 2:WHIPPLE CITY FAMILY CHIROPRACTIC
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-1215
Mailing Address - Country:US
Mailing Address - Phone:518-692-8584
Mailing Address - Fax:518-692-8597
Practice Address - Street 1:128 MAIN ST
Practice Address - Street 2:WHIPPLE CITY FAMILY CHIROPRACTIC
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-1215
Practice Address - Country:US
Practice Address - Phone:518-692-8584
Practice Address - Fax:518-692-8597
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0109851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA5568OtherMEDICARE-PTAN