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General NPI Number Information
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NPI Number | 1841517489
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Entity Type | Individual
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Provider Name | DANIEL DEXEUS D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 27005 76TH AVE DEPARTMENT OF EMERGENCY MEDICINE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 718-470-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 403 12TH ST APARTMENT 3
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City | BROOKLYN
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State | NY
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Zip | 11215-7319
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Country | US
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Telephone | 347-351-0606
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 254172
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License Number State | NY
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