Provider Demographics
NPI:1235579913
Name:DUQUE, ANGELA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIA
Last Name:DUQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:MARIA
Other - Last Name:DUQUE HENAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:92 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2018
Mailing Address - Country:US
Mailing Address - Phone:787-309-4244
Mailing Address - Fax:
Practice Address - Street 1:8340 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7824
Practice Address - Country:US
Practice Address - Phone:718-850-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine