Individual
DR. KEITH PHILIP PASICHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 2ND AVE # C110, LONG BRANCH, NJ 07740-6303
(732) 923-6210
(888) 487-1131
Mailing address
2147 ROUTE 27 STE 101, EDISON, NJ 08817-3365
(609) 570-4800
(888) 487-1131
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
25MA10208200
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
D0104049
MD
207RA0401X
Addiction Medicine (Internal Medicine) Physician
MD459333
PA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
25MA10208200
NJ
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
D0104049
MD
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD459333
PA
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
25MA10208200
NJ
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
D0104049
MD
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
MD459333
PA
208VP0000X
Pain Medicine Physician
D0104049
MD
208VP0000X
Pain Medicine Physician
MD459333
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04301277
—
NY
05
—
0682136
—
NJ
05
—
1035864390001
—
PA
Enumeration date
07/04/2010
Last updated
11/03/2025
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