Provider Demographics
NPI:1942568639
Name:DEBOW, D'ARTAGNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:D'ARTAGNAN
Middle Name:
Last Name:DEBOW
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 1:30 QUINTARD ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2534
Mailing Address - Country:US
Mailing Address - Phone:212-203-6171
Mailing Address - Fax:
Practice Address - Street 1:141 7TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2270
Practice Address - Country:US
Practice Address - Phone:212-203-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287513-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery