Provider Demographics
NPI:1134734189
Name:DEPAS, ASIA
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:DEPAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WILLOUGHBY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1585
Mailing Address - Country:US
Mailing Address - Phone:908-404-2178
Mailing Address - Fax:
Practice Address - Street 1:80 W GRAND ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1471
Practice Address - Country:US
Practice Address - Phone:908-354-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health