JEAN ROBERT DESROULEAUX (NPI# 1609809169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609809169 |
| Entity Type | Individual |
| Full Name | JEAN ROBERT DESROULEAUX |
| Credential | MD |
| Practice Address |
900 Franklin Ave Valley Stream NY 11580-2145 |
| Mailing Address |
Po Box 33354 Hartford CT 06150-3354 |
| Practice Telephone | 8003765566 |
| Mailing Telephone | 8003765566 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
181744 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01485318 | 05 |
| Street Address |
900 FRANKLIN AVE |
| City | VALLEY STREAM |
| State | NY |
| Zip Code | 11580-2145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285639591 | Jerald Darvishzadeh | Anesthesiology | 900 Franklin Ave, Anesthesia Department, Valley Stream, NY 11580-2145 | 2005-06-15 |
| 1205442100 | Madeleine Ann Reyes | Surgery | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-09-17 |
| 1376153700 | Mei L Lu | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-07-31 |
| 1508484858 | Virghinya Ridwan | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-07-13 |
| 1588298806 | Melissa Lopez | Nurse Practitioner | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-02-25 |
| 1659918316 | Nassau Spine Intraop Monitoring Medical | Specialist/Technologist, Other | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-12-02 |
| 1841841145 | Hannah Elizabeth Mathew | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-27 |
| 1972154565 | Karim Mohamed | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-25 |
| 1992354427 | Jessy Mathew | Nurse Practitioner | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-07 |
| 1073162913 | Nicholas Crozier | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807276 | Jason Diana Lmsw | Clinic/Center | 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 | 2020-10-09 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1427523869 | Jessica Doyle | Social Worker | 5-11 Pflug Pl, Valley Stream, NY 11580 | 2018-10-12 |
| 1013491026 | Syeda Afshan Firdous | Licensed Practical Nurse | 13 Cleaveland St, Valley Stream, NY 11580 | 2018-09-17 |
| 1700377934 | Jisha Merin Mathew | Nurse Practitioner | 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 | 2018-05-23 |
| 1669970273 | Terrice Bell | Social Worker | 50 W Hawthorne Avenue, Valley Streams, NY 11580 | 2018-01-29 |
| 1659883718 | Rita M. Fowler | Registered Nurse | 33 West Hawthorne Ave. Suite 31, New York Health Care, Valley Stream, NY 11580 | 2017-10-30 |
| 1881104768 | Sharon Stephenson | Peer Specialist | 51 Foster Avenue, North Valley Stream, Valley Stream, NY 11580 | 2017-10-05 |
| 1356850200 | Barry Henderson | Case Manager/Care Coordinator | 23 Marlow Road, Valley Stream, NY 11580 | 2017-09-22 |
| 1922526565 | Aneta Kaczmarski | Physical Therapy Assistant | 299 North Corona Ave, Valley Stream, NY 11580 | 2017-09-05 |
| Find all providers in zip 11580 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568926822 | Frederic A Mendelsohn Neurodiagnostics Inc | Radiology | 30 Seaside Dr, Port Jefferson, NY 11777-1132 | 2019-01-30 |
| 1639580244 | Julian Felder | Radiology | 20 Markwood Rd, Forest Hills, NY 11375-6050 | 2014-05-16 |
| 1982045845 | Reade Andrew De Leacy | Radiology | 1450 Madison Avenue, Box 1136, Klingenstein Clinical Center, 1-north, New York, NY 10029-6574 | 2013-07-08 |
| 1053653733 | Joanne Michelle Rispoli | Radiology | 560 1st Ave # 2, New York, NY 10016-6402 | 2013-03-20 |
| 1619215167 | Asim Maher | Radiology | 8342 241st St, Bellerose, NY 11426 | 2013-01-17 |
| 1568727121 | Akm Ashfaqur Rahman | Radiology | 23 Hadley Ct, Pittsford, NY 14534-2838 | 2012-07-10 |
| 1740554286 | Branch Medical, PC | Radiology | 35 Pinelawn Rd., Suite 112, Melville, NY 11747 | 2012-03-01 |
| 1437426483 | John William Duncan | Radiology | 7 E 14th St Apt 201, New York, NY 10003-3117 | 2011-11-18 |
| 1750685806 | Prachi Dubey | Radiology | 630 W168th Street # 28, New York, NY 10032 | 2011-01-04 |
| 1275850810 | Joseph Dobtsis | Radiology | 1445 Shore Pkwy Apt 4t, Brooklyn, NY 11214-6142 | 2010-04-21 |
| Find all providers with the same taxonomy | ||||
| City | VALLEY STREAM |
| Zip Code | 11580 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.