Most Relevant Information
Provider Data
| NPI Number: | 1003258617 |
| Provider Name: | DANIELLE DEBAUN |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 499883111 |
Most Important Dates
| Enumeration Date: | 07/24/2013 |
| Last Updated: | 07/24/2013 |
Provider Practice Location
3 S LEWIS PL
ROCKVILLE CENTRE
NY
115705529
Practice Location Phone/Fax
| Phone: | 5166525983 |
| Fax: |
Provider Mailing Location
3 S LEWIS PL
ROCKVILLE CENTRE
NY
115705529
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |