Individual
FERNAND F THEOGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
650 ASHFORD ST, BROOKLYN, NY 11207-7315
(718) 345-5000
(718) 345-5794
Mailing address
592 ROCKAWAY AVE, BROOKLYN, NY 11212-5539
(718) 345-5000
(718) 345-5794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
196985
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01847281
—
NY
Enumeration date
04/25/2006
Last updated
07/09/2018
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