N.Y. Rosedale Medical P.C

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

N.Y. ROSEDALE MEDICAL P.C

Practice address

121 Graham Ave
Brooklyn, NY 11206-2609

Phone

(718) 963-0073

Fax

(718) 963-0277

NPI assigned

May 3, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jean R Dupoux, MD

Title

President

Phone

(718) 963-0073

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1477812907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062609",
            "telephone_number": "718-963-0073",
            "fax_number": "718-963-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062609",
            "telephone_number": "718-963-0073",
            "fax_number": "718-963-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N.Y. ROSEDALE MEDICAL P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "DUPOUX",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-963-0073",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.