Individual
MRS. MICHELLE RENEE PASTERNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSW C
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04851
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016
BSDC INDIVIDUAL
—
01
—
002668
VAL INDIVIDUAL
—
01
—
150N
MBMD GROUP
—
01
—
150N124G
MBMD INDIVIDUAL
—
01
—
2139989
MAMS INDIVIDUAL
—
01
—
226570
KAIS INDIVIDUAL
—
01
—
252450
COMP GROUP
—
01
—
253552
COMP INDIVIDUAL
—
01
—
331947
MHN INDIVIDUAL
—
01
—
360218
MHN GROUP
—
01
—
52317109
BSMD INDIVIDUAL
—
01
—
705BPS
BSMD GROUP
—
01
—
K452
BSDC GROUP
—
01
—
PVPB119420
APS INDIVIDUAL
—
Enumeration date
06/02/2006
Last updated
07/08/2007
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