Provider Demographics
NPI:1104082023
Name:DENNIS A. PASTENA, M.D., P.C.
Entity type:Organization
Organization Name:DENNIS A. PASTENA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PASTENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-278-9009
Mailing Address - Street 1:667 STONELEIGH AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2454
Mailing Address - Country:US
Mailing Address - Phone:845-278-9009
Mailing Address - Fax:845-278-9091
Practice Address - Street 1:667 STONELEIGH AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:845-278-9009
Practice Address - Fax:845-278-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121096208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY121096-2BOtherWORKERS COMP
NYA100000285Medicare PIN
NYB13515Medicare UPIN