Provider Demographics
NPI:1205210002
Name:PASKOSKI, CHRISTIE EMILY (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:EMILY
Last Name:PASKOSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:400 VALLEY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-2316
Mailing Address - Country:US
Mailing Address - Phone:973-770-7101
Mailing Address - Fax:973-770-7108
Practice Address - Street 1:400 VALLEY RD STE 105
Practice Address - Street 2:
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-2316
Practice Address - Country:US
Practice Address - Phone:973-770-7101
Practice Address - Fax:973-770-7108
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00367900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant