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General NPI Number Information
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NPI Number | 1144282997
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Entity Type | Individual
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Provider Name | PATRICK ANTHONY DERESPINIS SR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2504 RICHMOND RD.
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City | STATEN ISLAND
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State | NY
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Zip | 10306
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Country | US
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Telephone | 718-667-1010
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Fax | 718-667-9217
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Provider Business Mailing Address
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Address Line | 3 RICHMONDE CT
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City | COLTS NECK
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State | NJ
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Zip | 07722-1072
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Country | US
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Telephone | 732-975-9875
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Fax | 732-975-9835
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 151934
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License Number State | NY
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