Individual
JEAN ROBERT DESROULEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(800) 376-5566
Mailing address
PO BOX 33354, HARTFORD, CT 06150-3354
(800) 376-5566
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
181744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01485318
—
NY
Enumeration date
07/08/2006
Last updated
07/08/2007
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