Provider Demographics
NPI:1851511976
Name:PROOPS, DOUGLAS CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:CHARLES
Last Name:PROOPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 BROADWAY
Mailing Address - Street 2:RM 831 BOX 72
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3990
Mailing Address - Country:US
Mailing Address - Phone:212-442-8468
Mailing Address - Fax:212-442-8452
Practice Address - Street 1:1309 FULTON AVE 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456
Practice Address - Country:US
Practice Address - Phone:718-579-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22893512083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine