Individual
JEAN M DAUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 BEDFORD AVE, BROOKLYN, NY 11216-4117
(718) 484-8818
(732) 440-1483
Mailing address
1530 BEDFORD AVE, BROOKLYN, NY 11216-4117
(718) 484-8818
(732) 440-1483
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
191222
NY
207RH0003X
Hematology & Oncology Physician
Primary
191222
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01605403
—
NY
Enumeration date
05/17/2006
Last updated
09/13/2021
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