- Practice location
- 450 Clarkson Ave, Brooklyn, NY 11203-2012
- Phone
- 718-270-1000
- Fax
- —
- Last updated
- October 26, 2020
Ketisha Angelica De Roche is an Internal Medicine, Gastroenterology based in Brooklyn, NY. Ketisha Angelica De Roche practices in Brooklyn, NY and has the professional credentials of MD. The NPI Number for Ketisha Angelica De Roche is 1790119493 and holds a License No. 283786 (MA). The current practice location address for Ketisha Angelica De Roche is 450 Clarkson Ave, Brooklyn, NY 11203-2012 and can be reached out via phone at 718-270-1000.
Provider Profile Details
- NPI Number
- 1790119493
- Provider Name
- Ketisha Angelica De Roche
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 450 Clarkson Ave, Brooklyn, NY 11203-2012
- Phone Number
- 718-270-1000
- Primary Taxonomy
- Internal Medicine, Gastroenterology · 207RG0100X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 29, 2013
- Last Update Date
- October 26, 2020
- Certification Date
- October 26, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 450 Clarkson Ave
Brooklyn, NY 11203-2012 - City
- Brooklyn
- State
- New York
- Zip
- 11203-2012
- Phone Number
- 718-270-1000
Provider Business Mailing Address Details
- Address
- 450 Clarkson Avenue
Suny Downstate
Brooklyn, NY 10023 - City
- Brooklyn
- State
- NY
- Zip
- 10023
- Phone Number
- 718-270-1000
- Fax Number
- 718-579-4836
License Information
- License Number
- 283786
- License State
- MA
- Taxonomy
- Internal Medicine, Gastroenterology · 207RG0100X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ketisha A De Roche, MD?
The NPI number of Ketisha A De Roche, MD is 1790119493. It was assigned on August 29, 2013 and is currently active in the NPPES registry.
What is the specialty of Ketisha A De Roche, MD?
Ketisha A De Roche, MD is registered under the primary taxonomy Internal Medicine, Gastroenterology (code 207RG0100X), licensed in MA under license number 283786.
Where does Ketisha A De Roche, MD practice?
The practice location is 450 Clarkson Ave, Brooklyn, NY 11203-2012. The office can be reached at 718-270-1000 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790119493 directly on the NPPES registry website.