Desrouleaux, Jean Robert

Desrouleaux, Jean Robert is an individual health care provider with primary practice located at 900 Franklin Ave , Valley Stream NY 11580-2145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neuroradiology, which is considered as his primary health care specialty. Desrouleaux, Jean Robert can be contacted via phone (800) 376-5566.

Contact Information

Primary practice address
900 Franklin Ave Valley Stream NY 11580-2145
Phone: (800) 376-5566
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 181744 New York

Profile Details

NPI number 1609809169
LBN Legal business name Desrouleaux, Jean Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609809169 NPPES
New York MEDICAID 01485318

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