Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 210720 | NY |
NPI | 1982611125 |
---|---|
Provider Name | Dr. Suzy Bibawy |
First Address | Staten Island, NY 10301-4639 |
Second Address | Staten Island, NY 10304-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 03/11/2015 |