Provider Demographics
NPI:1396956819
Name:PASCUCCI, JONATHAN JOSEPH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JOSEPH
Last Name:PASCUCCI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 W 56TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-7813
Mailing Address - Country:US
Mailing Address - Phone:516-695-1709
Mailing Address - Fax:
Practice Address - Street 1:2681 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4412
Practice Address - Country:US
Practice Address - Phone:212-865-5360
Practice Address - Fax:212-678-4698
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist