Provider Demographics
NPI:1164499430
Name:DIPASQUALE, LAURENE (MD)
Entity Type:Individual
Prefix:
First Name:LAURENE
Middle Name:
Last Name:DIPASQUALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LANGERFELD RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1008
Mailing Address - Country:US
Mailing Address - Phone:201-664-8663
Mailing Address - Fax:201-664-8705
Practice Address - Street 1:466 OLD HOOK RD STE 24D
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1368
Practice Address - Country:US
Practice Address - Phone:201-218-0983
Practice Address - Fax:201-664-8705
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-04
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA049846207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE55032Medicare UPIN
NJ107078Medicare ID - Type Unspecified