Individual
EWALD J ANTOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
108-19 ROCKAWAY BLVD, OZONE PARK, NY 11420
(718) 845-2620
(718) 845-9380
Mailing address
1365 LEONARD WAY, N.VALLEY STREAM, NY 11580
(718) 845-2620
(718) 845-9380
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
00167153
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00167153
—
NY
Enumeration date
01/03/2007
Last updated
07/08/2007
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