Basic Information
| Provider Information | |||||||||
| NPI: | 1265687651 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DIPASQUA | ||||||||
| FirstName: | AIMEE | ||||||||
| MiddleName: | DORA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 THORN AVE | ||||||||
| Address2: | BOX 631 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141272600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166622040 | ||||||||
| FaxNumber: | 7166620019 | ||||||||
| Practice Location | |||||||||
| Address1: | MILLARD FILLMORE HOPSITAL, 3 GATES CIRCLE | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168875800 | ||||||||
| FaxNumber: | 7168875801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2008 | ||||||||
| LastUpdateDate: | 02/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 248915 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.