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1861569030

NPI Code Detail

MEDICARE: DR. JACQUES CLAUDEL ANTOINE MD

MEDICARE: DR. JACQUES CLAUDEL ANTOINE MD

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	188900	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	:	1861569030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUES CLAUDEL ANTOINE MD

Provider Business Mailing Address
First Line	:	1718 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212
Country	:	US
Telephone Number	:	718-485-9869
Fax Number	:	718-485-4213

Provider Business Practice Location Address
First Line	:	1718 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212
Country	:	US
Telephone Number	:	718-485-9869
Fax Number	:	718-485-4213

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JACQUES CLAUDEL ANTOINE MD” Practice Location

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