Individual
JACQUES DUPERVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 PLAZA ST E, SUITE S-3, BROOKLYN, NY 11238-5040
(718) 783-5168
(718) 783-0408
Mailing address
60 PLAZA ST E, SUITE S-3, BROOKLYN, NY 11238-5040
(718) 783-5168
(718) 783-0408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
182104
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01476379
—
NY
Enumeration date
04/26/2006
Last updated
07/28/2010
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