MEDICARE: DR. JEAN RAPHAEL YVON DUPOUX 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
1	207R00000X	Internal Medicine Physician	178289	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255458618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN RAPHAEL YVON DUPOUX M.D.

Provider Business Mailing Address
First Line	:	24812 139TH AVE
Second Line	:
City	:	ROSEDALE
State	:	NY
Zip	:	11422-2205
Country	:	US
Telephone Number	:	718-276-6043
Fax Number	:

Provider Business Practice Location Address
First Line	:	COMPREHENSIVE HEALTH CARE & REHABILITATION SVC., LLC
Second Line	:	148 WILSON AVE
City	:	BROOKLYN
State	:	NY
Zip	:	11237-3149
Country	:	US
Telephone Number	:	718-455-5500
Fax Number	:	718-455-8700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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