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General NPI Number Information
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NPI Number | 1114382090
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Entity Type | Organization
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Legal Business Name | JACQUELYN S. LAHOUD, M.D. P.C.
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 7515 13TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11228-2409
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Country | US
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Telephone | 917-414-4505
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Fax |
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Provider Business Mailing Address
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Address Line | 9917 SHORE RD APT 4C
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City | BROOKLYN
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State | NY
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Zip | 11209-7925
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Country | US
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Telephone | 917-414-4505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACQUELYN S LAHOUD
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Credential | M.D.
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Telephone | 917-414-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 272160
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License Number State | NY
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