| Jean Robert Desrouleaux Md,pc | |
|
175 Fulton Ave Suite 208 Hempstead NY 11550-3718 | |
| (516) 292-7443 | |
| (516) 483-7847 |
| Full Name | Jean Robert Desrouleaux Md,pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 175 Fulton Ave, Hempstead, New York |
| Authorized Official Name and Position | Jean-robert Desrouleaux (PRESIDENT) |
| Authorized Official Contact | 5162927443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jean Robert Desrouleaux Md,pc 10 Grace Lane Oyster Bay NY 11771-4020 Ph: (516) 292-7443 | Jean Robert Desrouleaux Md,pc 175 Fulton Ave Suite 208 Hempstead NY 11550-3718 Ph: (516) 292-7443 |
| NPI Number | 1588811665 |
|---|---|
| Provider Enumeration Date | 08/20/2008 |
| Last Update Date | 09/23/2008 |
| Medicare PECOS PAC ID | 1052354008 |
|---|---|
| Medicare Enrollment ID | O20050609001061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588811665 | NPI | - | NPPES |
| 01485318 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 181744 (New York) | Primary |
| Provider Name | Jean Robert Desrouleaux |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609809169 PECOS PAC ID: 8325001605 Enrollment ID: I20041108000790 |
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