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NPI 1982761474

NPI 1982761474 : GABRIEL DUGUE MD : NEW HYDE PARK, NY

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General NPI Number Information
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    NPI Number           |    1982761474
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    Entity Type          |    Individual 
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    Provider Name        |    GABRIEL DUGUE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/03/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4 LINCOLN AVENUE 
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    City                 |    NEW HYDE PARK
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    State                |    NY
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    Zip                  |    11040-3125
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    Country              |    US
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    Telephone            |    516-775-4276
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    Fax                  |    516-775-4278
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Provider Business Mailing Address
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    Address Line         |    4 LINCOLN AVENUE 
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    City                 |    NEW HYDE PARK
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    State                |    NY
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    Zip                  |    11040-3125
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    Country              |    US
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    Telephone            |    516-775-4276
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    Fax                  |    516-775-4278
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    175647
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    License Number State |    NY
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