Provider Demographics
NPI:1427217140
Name:GASPARIS, DEMETRIOS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIOS
Middle Name:
Last Name:GASPARIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HOOPER RD
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3646
Mailing Address - Country:US
Mailing Address - Phone:607-754-3863
Mailing Address - Fax:607-754-5697
Practice Address - Street 1:415 HOOPER RD
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-3646
Practice Address - Country:US
Practice Address - Phone:607-754-3863
Practice Address - Fax:607-754-5697
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine