Provider Demographics
NPI:1801943048
Name:REMY, PROSPERE (MD)
Entity type:Individual
Prefix:
First Name:PROSPERE
Middle Name:
Last Name:REMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:860 GRAND CONCOURSE
Mailing Address - Street 2:1K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2814
Mailing Address - Country:US
Mailing Address - Phone:718-585-5060
Mailing Address - Fax:718-585-4866
Practice Address - Street 1:860 GRAND CONCOURSE APT 1K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2815
Practice Address - Country:US
Practice Address - Phone:718-585-5060
Practice Address - Fax:718-585-4866
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY184493207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF47385Medicare UPIN