Provider Demographics
NPI:1871338863
Name:DEPASQUALE, RYLEY ANNE (LPN)
Entity type:Individual
Prefix:
First Name:RYLEY
Middle Name:ANNE
Last Name:DEPASQUALE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E DOUGHTY ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2939
Mailing Address - Country:US
Mailing Address - Phone:716-467-8325
Mailing Address - Fax:
Practice Address - Street 1:351 LAKE SHORE DR E
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-1354
Practice Address - Country:US
Practice Address - Phone:716-467-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347608164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse