Individual
JOSEPH ROBERT PASTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-0612
Mailing address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
(918) 481-5170
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0105824
OK
367500000X
Certified Registered Nurse Anesthetist
RN402525
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PTAN
OH
01
—
PENDING
CAQH
—
05
—
PENDING
—
OH
Enumeration date
05/23/2017
Last updated
01/29/2025
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