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General NPI Number Information
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NPI Number | 1114188869
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Entity Type | Individual
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Provider Name | PETER GERARD GASPARO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 7707 AUSTIN RD
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City | STOCKTON
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State | CA
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Zip | 95215-8312
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Country | US
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Telephone | 203-952-2773
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | RIDGEFIELD
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State | CT
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Zip | 06877-8909
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Country | US
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Telephone | 203-952-2773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 180840-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-19542-0
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 041726
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C1-0023937
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME119950
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G71424
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License Number State | CA
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