Active NPI
Pasquale Depetris, PH.D
- Psychologist
- Long Island City, NY
National Provider Identifier
1306982756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 009139
- Practice address
- 4136 27TH St
Long Island City, NY 11101-3825 - Phone
- (718) 389-5100
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 009139 | NY | Primary |
Addresses
Primary practice location
4136 27TH St
Long Island City, NY 11101-3825
Mailing address
4136 27TH St
Long Island City, NY 11101-3825
Phone (718) 389-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steinway Child and Family Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Howard Beach, NY
- NPI 1346286382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306982756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4136 27TH ST",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111013825",
"telephone_number": "718-389-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4136 27TH ST",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111013825",
"telephone_number": "718-389-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEPETRIS",
"first_name": "PASQUALE",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "009139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.