Basic Information
| Provider Information | |||||||||
| NPI: | 1053447342 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESROSIERS | ||||||||
| FirstName: | ANNE-MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 E 38TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032820 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1545 ATLANTIC AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112131122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186134000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0104X | 199325 | NY | Y | Allopathic & Osteopathic Physicians | Pathology | Chemical Pathology |
No ID Information.