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1114055043
LULU H IBANEZ
BRONX, NY
NPI
1114055043
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 0092621)
Enumeration Date
2007-03-01
Last Update Date
2007-07-08
Business Address
-- LULU H IBANEZ RPAC
4422 3RD AVE
BRONX, NY 10457-2545
Phone number: 718-960-9000
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Mailing Address
-- LULU H IBANEZ RPAC
51 LINCOLN AVE #B2
ROCKVILLE CENTRE, NY 11570-5750
Phone number: 516-536-1735
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