Provider Demographics
NPI:1033526850
Name:DEPAOLA, JOSEPH NICHOLAS (NP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:NICHOLAS
Last Name:DEPAOLA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MADISON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5455
Mailing Address - Country:US
Mailing Address - Phone:212-203-1773
Mailing Address - Fax:
Practice Address - Street 1:315 MADISON AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5455
Practice Address - Country:US
Practice Address - Phone:212-203-1773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401734363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY401734OtherNEW YORK STATE OFFICE OF THE PROFESSIONS