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General NPI Number Information
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NPI Number | 1750375416
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Entity Type | Individual
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Provider Name | JOSEPH ABOUJAOUDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 11/18/2023
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Provider Practice Location Address
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Address Line | 65 ROSE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2246
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Country | US
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Telephone | 718-354-3320
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Fax | 718-979-3321
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Provider Business Mailing Address
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Address Line | 65 ROSE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2246
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Country | US
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Telephone | 718-354-3320
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Fax | 718-979-3321
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 210459
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License Number State | NY
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