Provider Demographics
NPI:1174232185
Name:GASPAR, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:GASPAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PROCTOR
Mailing Address - State:VT
Mailing Address - Zip Code:05765-1044
Mailing Address - Country:US
Mailing Address - Phone:908-420-1061
Mailing Address - Fax:
Practice Address - Street 1:40 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:PROCTOR
Practice Address - State:VT
Practice Address - Zip Code:05765-1044
Practice Address - Country:US
Practice Address - Phone:908-420-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program