Individual
DR. A JACQUES GUILLAUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22767 114TH AVE, CAMBRIA HEIGHTS, NY 11411-1303
(718) 613-4080
(718) 613-4257
Mailing address
22767 114TH AVE, CAMBRIA HEIGHTS, NY 11411-1303
(718) 613-4080
(718) 613-4257
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
128962
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00641378
—
NY
Enumeration date
07/06/2006
Last updated
07/09/2007
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