Provider Demographics
NPI:1053780510
Name:MEDICAL PRACTICE OF JEAN-FRANCOIS & LAROCHE, PC
Entity type:Organization
Organization Name:MEDICAL PRACTICE OF JEAN-FRANCOIS & LAROCHE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTORE
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JEAN-FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-693-2800
Mailing Address - Street 1:622 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4403
Mailing Address - Country:US
Mailing Address - Phone:718-693-2800
Mailing Address - Fax:718-693-3724
Practice Address - Street 1:622 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4403
Practice Address - Country:US
Practice Address - Phone:718-693-2800
Practice Address - Fax:718-693-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154993207R00000X
NY1595642080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty