Provider Demographics
NPI:1205894151
Name:PALASCAK, JOSEPH EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:PALASCAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 EDEN AVE
Mailing Address - Street 2:ML 0508
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267
Mailing Address - Country:US
Mailing Address - Phone:513-558-2184
Mailing Address - Fax:513-558-2124
Practice Address - Street 1:3125 EDEN AVE
Practice Address - Street 2:ML 0508
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267
Practice Address - Country:US
Practice Address - Phone:513-558-2184
Practice Address - Fax:513-558-2124
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-046787207R00000X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200123940Medicaid
OH0490464Medicaid
KY64769482Medicaid
IN200123940Medicaid
OHPA0506282Medicare PIN