Provider Demographics
NPI:1699863639
Name:PASTOREK, NORMAN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:JOSEPH
Last Name:PASTOREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EAST 88TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0535
Mailing Address - Country:US
Mailing Address - Phone:212-987-4700
Mailing Address - Fax:212-987-4217
Practice Address - Street 1:12 EAST 88TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0535
Practice Address - Country:US
Practice Address - Phone:212-987-4700
Practice Address - Fax:212-987-4217
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103461207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B18383Medicare UPIN