Provider Demographics
NPI:1861844011
Name:HERCULES-FRANCOIS, DESARY
Entity Type:Individual
Prefix:MRS
First Name:DESARY
Middle Name:
Last Name:HERCULES-FRANCOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DESARY
Other - Middle Name:
Other - Last Name:HERCULES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1800 DR MARTIN L KING JR BLVD
Mailing Address - Street 2:1J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4598
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002788286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital