Peter Thomas Dupre, SLP-CCC
Individual provider Active NPI Speech-Language Pathologist · Endicott, NY
NPI 1023301686 · NPPES record last updated Mar 19, 2015
Key facts
- NPI
- 1023301686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 020939-1 (NY)
- Practice address
- 629 Church St
Endicott, NY 13760-4509 - Phone
- (607) 222-8217
- NPI assigned
- May 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020939-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 020939-1 | NY | Yes |
Addresses
Primary practice location
629 Church St
Endicott, NY 13760-4509
Mailing address
629 Church St
Endicott, NY 13760-4509
Phone (607) 222-8217
Other providers in Endicott, NY
- Dinosaur Dental, PLLC
- Dinosaur Orthodontics PLLC
- Dr. Marianne Soden Serjanej DO PLLC
- Subu Dubey
- Paige Dufresne
- Civita Dyer
- Daniel S Eckman-Camera
- Mark C Egner
- Leslie Estelle Eldridge
- Endicott Dental Surgery, PLLC
All providers in Endicott, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.