Healthcare Provider Details

I. General information

NPI: 1720387046
Provider Name (Legal Business Name): JACQUES SERGE PARISIEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 COURT ST
BROOKLYN NY
11231-4335
US

IV. Provider business mailing address

337 COURT ST
BROOKLYN NY
11231-4335
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-6833
  • Fax: 718-686-6832
Mailing address:
  • Phone: 718-686-6833
  • Fax: 718-686-6832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number108462
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number108462
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: