Provider Demographics
NPI:1538603154
Name:PASCIAK, ALEXANDER S (MS, MD, PHD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:S
Last Name:PASCIAK
Suffix:
Gender:M
Credentials:MS, MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 N BROADWAY STE 147
Mailing Address - Street 2:THE JOHNS HOPKINS SCHOOL OF MEDICINE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1832
Mailing Address - Country:US
Mailing Address - Phone:410-955-3080
Mailing Address - Fax:
Practice Address - Street 1:827 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4606
Practice Address - Country:US
Practice Address - Phone:410-225-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2019-05-09
Deactivation Date:2019-04-17
Deactivation Code:
Reactivation Date:2019-05-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program