Provider Demographics
NPI:1245409499
Name:DEPASQUALE, CHRISTOPHER LEE (BACHELOR OF NS DOCTO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:DEPASQUALE
Suffix:
Gender:M
Credentials:BACHELOR OF NS DOCTO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UNION ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224
Mailing Address - Country:US
Mailing Address - Phone:716-675-4444
Mailing Address - Fax:716-675-4446
Practice Address - Street 1:100 UNION ROAD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224
Practice Address - Country:US
Practice Address - Phone:716-675-4444
Practice Address - Fax:716-675-4446
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0272961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist