1952650129 NPI number — DR. ASHLEY C DEPASQUALE WHITE PT, DPT

Table of content: DR. ASHLEY C DEPASQUALE WHITE PT, DPT (NPI 1952650129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952650129 NPI number — DR. ASHLEY C DEPASQUALE WHITE PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
ASHLEY
Provider Middle Name:
C DEPASQUALE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEPASQUALE
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952650129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 EAST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITINSVILLE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01588-1923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-234-1332
Provider Business Mailing Address Fax Number:
508-234-1335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 EAST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITINSVILLE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01588
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-234-1332
Provider Business Practice Location Address Fax Number:
508-234-1335
Provider Enumeration Date:
09/04/2012

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: 225100000X , with the licence number:  20178 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 20178 . This is a "MASSACHUSETTS LICENSE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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