Gregory James Deppas

Individual provider Active NPI Physical Therapist · Irving, NY

NPI 1972149847 · NPPES record last updated Nov 26, 2019

Key facts

NPI
1972149847
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
044642 (NY)
Practice address
845 Main Road
Irving, NY 14081
Phone
(716) 951-7000
NPI assigned
Nov 26, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
044642NYMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 044642 NY Yes

Addresses

Primary practice location

845 Main Road
Irving, NY 14081

Mailing address

410 Campus Dr Apt 1
Buffalo, NY 14226-3627
Phone (716) 338-6490

Other providers in Irving, NY

All providers in Irving, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.