IAN CARLO DEJESUS

BROOKLYN, NY
NPI1952484719
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  p47235)
Enumeration Date2006-10-23
Last Update Date2007-07-08
Business Address
-- IAN CARLO DEJESUS PA
760 BROADWAY
BROOKLYN, NY 11206-5317
Phone number: 171-896-3837
Mailing Address
-- IAN CARLO DEJESUS PA
20936 27TH AVE
BAYSIDE, NY 11360-2405
Phone number: 718-428-2420