Individual
DR. FABIENNE LARAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4209 28TH ST, NYCDOHMH DIVISION OF DISEASE CONTROL-BCD WS 5-71, LONG ISLAND CITY, NY 11101-4130
(347) 396-7415
Mailing address
4209 28TH ST, NYCDOHMH DIVISION OF DISEASE CONTROL-BCD WS 5-71, LONG ISLAND CITY, NY 11101-4130
(347) 396-7415
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2034311
NY
Other
Enumeration date
05/19/2006
Last updated
09/04/2015
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