Individual
DR. PAIGE MICHELLE PASTALOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-3663
(215) 707-6417
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3663
(215) 707-6417
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
2201001352
VA
231H00000X
Audiologist
Primary
AT006156
PA
237600000X
Audiologist-Hearing Aid Fitter
2101001621
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194803338
MEDICARE RAILROAD
VA
05
—
1194803338
—
VA
01
—
362426
ANTHEM
VA
Enumeration date
06/25/2008
Last updated
03/17/2018
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