Provider Demographics
NPI:1881075323
Name:PASCARELLA, RAFFAELLA (DPM)
Entity type:Individual
Prefix:
First Name:RAFFAELLA
Middle Name:
Last Name:PASCARELLA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 BLOOMFIELD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2480
Mailing Address - Country:US
Mailing Address - Phone:860-243-2951
Mailing Address - Fax:
Practice Address - Street 1:705 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2479
Practice Address - Country:US
Practice Address - Phone:860-243-2951
Practice Address - Fax:860-243-5790
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1006213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery