Provider Demographics
NPI:1831269505
Name:PASTERNACK, JENNIFER MARTINE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARTINE
Last Name:PASTERNACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 HEALING FARM LN
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-5808
Mailing Address - Country:US
Mailing Address - Phone:828-894-5557
Mailing Address - Fax:828-894-7120
Practice Address - Street 1:101 HEALING FARM LN
Practice Address - Street 2:
Practice Address - City:MILL SPRING
Practice Address - State:NC
Practice Address - Zip Code:28756-5808
Practice Address - Country:US
Practice Address - Phone:828-894-5557
Practice Address - Fax:828-894-7120
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-000452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026958401OtherUNIVERA
PA716205OtherHIGHMARK BLUE SHIELD
PA260050172OtherRAILROAD MEDICARE
PA001684240Medicaid
NC00530729Medicaid
NC00530729Medicaid