Provider Demographics
NPI:1326571225
Name:DUQUE-SUAREZ, ANYELA (DO)
Entity type:Individual
Prefix:
First Name:ANYELA
Middle Name:
Last Name:DUQUE-SUAREZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANYELA
Other - Middle Name:
Other - Last Name:DUQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8916 RUTLEDGE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7936
Mailing Address - Country:US
Mailing Address - Phone:347-952-6035
Mailing Address - Fax:
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304829208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06060113Medicaid