Individual
KARL A DESHRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 EAST MAIN ST, SOUTH BROOKHAVEN HEALTH CENTER WEST, PATCHOQUE, NY 11772
(631) 854-1307
(631) 854-1310
Mailing address
365 EAST MAIN ST, SOUTH BROOKHAVEN HEALTH CENTER WEST, PATCHOQUE, NY 11772
(631) 854-1307
(631) 854-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
132912
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01769864
—
NY
Enumeration date
08/05/2006
Last updated
03/10/2008
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