Provider Demographics
NPI:1396969325
Name:SARGIOTTO, PASQUALE (MED LCADC LPC)
Entity type:Individual
Prefix:
First Name:PASQUALE
Middle Name:
Last Name:SARGIOTTO
Suffix:
Gender:M
Credentials:MED LCADC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 ALEXANDER ROAD
Mailing Address - Street 2:BUILDING 2 SUITE 202
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-419-0400
Mailing Address - Fax:609-419-9200
Practice Address - Street 1:707 ALEXANDER ROAD
Practice Address - Street 2:BUILDING 2 SUITE 202
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-419-0400
Practice Address - Fax:609-419-9200
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00104600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor