Individual
BRIAN IBABAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
500 W MAIN ST STE 16, WYCKOFF, NJ 07481-1406
(201) 847-9320
(201) 847-0059
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA11741700
NJ
Other
Enumeration date
03/28/2019
Last updated
05/22/2023
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