Provider Demographics
NPI:1326874587
Name:DIPASQUALE, ZACHARY (PSYD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:DIPASQUALE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 ROUTE 66 STE 331
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7300
Mailing Address - Country:US
Mailing Address - Phone:813-226-7762
Mailing Address - Fax:
Practice Address - Street 1:4000 ROUTE 66
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7300
Practice Address - Country:US
Practice Address - Phone:732-988-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ243059390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program