Individual
MRS. KATHERINE E IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
177 FORT WASHINGTON AVE, ROOM 8-004, NEW YORK, NY 10032
(212) 304-6920
Mailing address
254 GROVE ST APT 3, JERSEY CITY, NJ 07302-4631
(609) 280-0852
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/04/2011
Last updated
06/06/2018
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