Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 176455 | NY |
NPI | 1043206469 |
---|---|
Provider Name | Jacqueline Dauhajre |
First Address | Long Island City, NY 11103-1621 |
Second Address | Jackson Heights, NY 11372-7011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01415030 | (05) | NY |
F49230 | (02) | NY |