Individual
PASQUALE DEPETRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
4136 27TH ST, LONG ISLAND CITY, NY 11101-3825
(718) 389-5100
Mailing address
4136 27TH ST, LONG ISLAND CITY, NY 11101-3825
(718) 389-5100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009139
NY
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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