Provider Demographics
NPI:1710446018
Name:VIZCARRA PASAPERA, JOAQUIN AUGUSTO (MD)
Entity type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:AUGUSTO
Last Name:VIZCARRA PASAPERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:3 GATES NEUROLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-3606
Mailing Address - Fax:215-829-6606
Practice Address - Street 1:330 SOUTH NINTH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6103
Practice Address - Country:US
Practice Address - Phone:215-662-3606
Practice Address - Fax:215-829-6606
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4805362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology