Individual
PHILIP LAURENCE DEJAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
710 W 168TH ST, NEW YORK, NY 10032-3726
(646) 426-3876
Mailing address
710 W 168TH ST FL 7, NEW YORK, NY 10032-3726
(646) 426-3876
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
217753
MA
2084N0400X
Neurology Physician
Primary
288067
NY
Other
Enumeration date
05/12/2006
Last updated
07/21/2022
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