Provider Demographics
NPI:1275879702
Name:DIPASQUALE, PATRICIA A (LPN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:DIPASQUALE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 CHERRY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4275
Mailing Address - Country:US
Mailing Address - Phone:585-966-4005
Mailing Address - Fax:585-581-8128
Practice Address - Street 1:244 CHERRY CREEK LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4275
Practice Address - Country:US
Practice Address - Phone:585-966-4005
Practice Address - Fax:585-581-8128
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146384164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse