Provider Demographics
NPI:1699855494
Name:PASQUARIELLO, DONALD J (DMD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:PASQUARIELLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DUPMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420
Mailing Address - Country:US
Mailing Address - Phone:973-831-7391
Mailing Address - Fax:973-942-8674
Practice Address - Street 1:55 UNION AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502
Practice Address - Country:US
Practice Address - Phone:973-942-2423
Practice Address - Fax:973-942-8674
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI151331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice