Individual
JACQUE P PASTERNACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
8080 ACADEMY RD NE STE B, ALBUQUERQUE, NM 87111-1110
(505) 244-0080
Mailing address
6801 JEFFERSON ST NE, SUITE 350, ALBUQUERQUE, NM 87109-4379
(505) 242-1711
(505) 242-0291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
81-PA009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000T9885
—
NM
05
—
T9885
—
NM
Enumeration date
02/23/2006
Last updated
08/15/2019
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