Provider Demographics
NPI:1215207683
Name:JACQUELINE DAUHAJRE, M.D., P.C.
Entity Type:Organization
Organization Name:JACQUELINE DAUHAJRE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUHAJRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-519-1171
Mailing Address - Street 1:75 E END AVE
Mailing Address - Street 2:#2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7909
Mailing Address - Country:US
Mailing Address - Phone:917-519-1171
Mailing Address - Fax:917-338-2607
Practice Address - Street 1:140 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0306
Practice Address - Country:US
Practice Address - Phone:646-553-5220
Practice Address - Fax:917-338-2607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176455207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty