Individual
DANIEL DESPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASST
Contact information
Practice address
888 FOUNTAIN AVE, BROOKLYN, NY 11208-5997
(718) 642-6352
(718) 642-7890
Mailing address
6 GERARD AVE EAST, MALVERNE, NY 11565
(516) 599-8380
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
001042
NY
363AS0400X
Surgical Physician Assistant
Primary
001042
NY
Other
Enumeration date
04/24/2007
Last updated
09/11/2025
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