1265687651 NPI number — AIMEE DORA DIPASQUA M.D.

Table of content: AIMEE DORA DIPASQUA M.D. (NPI 1265687651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265687651 NPI number — AIMEE DORA DIPASQUA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIPASQUA
Provider First Name:
AIMEE
Provider Middle Name:
DORA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265687651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 THORN AVE
Provider Second Line Business Mailing Address:
BOX 631
Provider Business Mailing Address City Name:
ORCHARD PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14127-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-662-2040
Provider Business Mailing Address Fax Number:
716-662-0019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MILLARD FILLMORE HOPSITAL, 3 GATES CIRCLE
Provider Second Line Business Practice Location Address:
8TH FLOOR
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-887-5800
Provider Business Practice Location Address Fax Number:
716-887-5801
Provider Enumeration Date:
11/26/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  248915 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)