Provider Demographics
NPI:1043416068
Name:DELBRUNE, SERGE L (MD)
Entity type:Individual
Prefix:
First Name:SERGE
Middle Name:L
Last Name:DELBRUNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 NASSAU STREET
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4333
Mailing Address - Country:US
Mailing Address - Phone:516-616-0375
Mailing Address - Fax:
Practice Address - Street 1:888 FOUNTAIN AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-5997
Practice Address - Country:US
Practice Address - Phone:718-642-2661
Practice Address - Fax:718-642-6303
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2324822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry