Provider Demographics
NPI:1861565822
Name:PASTERNACK, MICHAEL A (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:PASTERNACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CEDAR CREEK GRADE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2721
Mailing Address - Country:US
Mailing Address - Phone:540-545-7891
Mailing Address - Fax:540-545-7893
Practice Address - Street 1:609 CEDAR CREEK GRADE STE B
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2721
Practice Address - Country:US
Practice Address - Phone:540-545-7891
Practice Address - Fax:540-545-7893
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000718Medicare PIN
VA350000728Medicare PIN