Provider Demographics
NPI:1205097706
Name:PASCAL, SANDRA (DO)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:PASCAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEER TRL
Mailing Address - Street 2:
Mailing Address - City:NESQUEHONING
Mailing Address - State:PA
Mailing Address - Zip Code:18240-2114
Mailing Address - Country:US
Mailing Address - Phone:954-249-8694
Mailing Address - Fax:570-805-2218
Practice Address - Street 1:4227 MANOR DR
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-9451
Practice Address - Country:US
Practice Address - Phone:954-249-8694
Practice Address - Fax:570-805-2218
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015101207Q00000X
NY2444921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine