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Individual

DR. MARK STEVEN PASTERNACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15 PARKMAN ST, WAC 612, BOSTON, MA 02114-3117
(617) 726-5771
(617) 726-5411
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42794
MA
207RI0200X
Infectious Disease Physician
42794
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0169226
MA
01
703788
TUFTS HEALTH PLAN
MA
01
E05817
BCBS MA
MA
Enumeration date
04/25/2006
Last updated
10/04/2011
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