JEAN ROBERT DESROULEAUX MD NPI 1609809169

NPI Information

NPI: 1609809169
Provider Name: JEAN ROBERT DESROULEAUX, MD
Classification: Radiology - 2085N0700X
Entity Type: Individual

Specialization: Neuroradiology

PECOS Registration: Yes

Address:
900 FRANKLIN AVE
VALLEY STREAM, NY
ZIP 11580
Phone: (800) 376-5566
Get Directions

Jean Robert Desrouleaux, MD is a neuroradiology radiology in Valley Stream, NY. The provider is a radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. Jean Robert Desrouleaux, MD NPI is 1609809169. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

900 FRANKLIN AVE
VALLEY STREAM, NY
ZIP 11580-145
Phone: (800) 376-5566

The NPI 1609809169 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085N0700X	Radiology	Neuroradiology	181744	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	F60686	MEDICARE UPIN	NEW YORK
2	74H731	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	01485318	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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