Individual
CARISSA CAIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OLD COUNTRY RD STE C-103N, WESTBURY, NY 11590-5156
(516) 806-6969
Mailing address
8610 GRAND AVE APT 3C, ELMHURST, NY 11373-4307
(718) 679-3928
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1409694202
NY
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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