Provider Demographics
NPI:1710228556
Name:DSOUZA, EUNICE (MD)
Entity Type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 WINCHESTER BLVD
Mailing Address - Street 2:BLDG. 73
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2193
Mailing Address - Country:US
Mailing Address - Phone:718-264-3950
Mailing Address - Fax:718-264-3951
Practice Address - Street 1:8045 WINCHESTER BLVD
Practice Address - Street 2:BLDG. 73
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2193
Practice Address - Country:US
Practice Address - Phone:718-264-3950
Practice Address - Fax:718-264-3951
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1590422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64625Medicare UPIN