Individual
DR. EVERTON A. PROSPERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 CLARKSON AVE, SUITE A, BROOKLYN, NY 11203-2056
(718) 270-1531
(718) 270-1561
Mailing address
450 CLARKSON AVE, BOX 59, BROOKLYN, NY 11203-2056
(718) 270-8867
(718) 270-1794
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
226783-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02367173
—
NY
Enumeration date
09/13/2005
Last updated
04/17/2009
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