Provider Demographics
NPI:1972683423
Name:DE JESUS, MARIVI MACATANGAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIVI
Middle Name:MACATANGAY
Last Name:DE JESUS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:760 BROADWAY
Mailing Address - Street 2:DEPARTMENT OF ANESTHSIOLOGY AND PAIN MANAGEMENT 3A-30
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5317
Mailing Address - Country:US
Mailing Address - Phone:718-963-8000
Mailing Address - Fax:718-963-8501
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:DEPARTMENT OF ANESTHSIOLOGY AND PAIN MANAGEMENT 3A-30
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-963-8501
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2008-09-11
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Provider Licenses
StateLicense IDTaxonomies
NYL001934207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine