Individual
DR. STEPHEN DEROUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 1ST AVE, NEW YORK, NY 10016-6419
(718) 668-0620
Mailing address
520 1ST AVE, NEW YORK, NY 10016-6419
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
180374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180374
LICENSE
NY
Enumeration date
12/19/2014
Last updated
12/19/2014
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