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General NPI Number Information
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NPI Number | 1326107806
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Entity Type | Individual
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Provider Name | RICHARD DIPASQUALE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 451 CLARKSON AVE E BLDG 5TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11203-2057
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Country | US
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Telephone | 718-245-3612
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Fax |
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Provider Business Mailing Address
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Address Line | 241 149TH PL
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City | WHITESTONE
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State | NY
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Zip | 11357-1130
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Country | US
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Telephone | 718-767-6294
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 178402
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License Number State | NY
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