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Individual

DR. JOSE M POULOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
99 HILLSIDE AVE STE D, WILLISTON PARK, NY 11596-2306
(516) 739-2930
(516) 739-4870
Mailing address
150 LINCOLN AVE, MINEOLA, NY 11501-2541
(516) 739-3909

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
225615
NY

Other

Enumeration date
11/03/2006
Last updated
07/08/2007
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