Individual
EMILY C PASTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2070 OLD BRIDGE RD STE 103, LAKE RIDGE, VA 22192-2495
(703) 499-8787
(703) 499-8222
Mailing address
2070 OLD BRIDGE RD STE 103, LAKE RIDGE, VA 22192-2495
(703) 499-8787
(703) 499-8222
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001383
VA
231H00000X
Audiologist
3971
SC
231H00000X
Audiologist
AP1909
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433863099
—
ME
01
—
P00728623
MEDICARE RAILROAD PTAN GROUP CB0866
ME
Enumeration date
09/29/2008
Last updated
10/15/2023
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