Provider Demographics
NPI:1740575620
Name:DEPASQUALE, FEDERICO
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:
Last Name:DEPASQUALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 LEBANON CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1450
Mailing Address - Country:US
Mailing Address - Phone:412-502-0021
Mailing Address - Fax:412-502-0021
Practice Address - Street 1:1717 LEBANON CHURCH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-1450
Practice Address - Country:US
Practice Address - Phone:412-502-0021
Practice Address - Fax:412-502-0021
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039348L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist