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NPI Code Detail

MEDICARE: LIONEL EMANUEL DESROCHES M.D.

MEDICARE: LIONEL EMANUEL DESROCHES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician172523NY
2207R00000XInternal Medicine Physician172523NY

General Provider Information

NPI Number : 1003928987
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIONEL EMANUEL DESROCHES M.D.
Provider Business Mailing Address
First Line : 1975 LINDEN BLVD
Second Line : SUITE 105
City : ELMONT
State : NY
Zip : 11003-4025
Country : US
Telephone Number : 516-285-2850
Fax Number : 516-285-0038
Provider Business Practice Location Address
First Line : 22414 MERRICK BLVD
Second Line :
City : LAURELTON
State : NY
Zip : 11413-2023
Country : US
Telephone Number : 718-949-6433
Fax Number : 718-949-0331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/10/2021

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