Provider Demographics
NPI:1295073906
Name:PASCAL, JEAN GUISCARD
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:GUISCARD
Last Name:PASCAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 E 95TH ST
Mailing Address - Street 2:BETWEEN AVENUE N AND SEAVIEW
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5414
Mailing Address - Country:US
Mailing Address - Phone:718-531-5469
Mailing Address - Fax:
Practice Address - Street 1:1608 E 95TH ST
Practice Address - Street 2:BETWEEN AVENUE N AND SEAVIEW
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5414
Practice Address - Country:US
Practice Address - Phone:718-531-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency