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Individual

BIBI SHAW-MANGRU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSED

Contact information

Practice address
328 E 62ND ST, NEW YORK, NY 10065-8206
(212) 752-7575
Mailing address
9109 213TH ST, QUEENS VILLAGE, NY 11428-1121
(347) 531-9039

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
03/28/2012
Last updated
03/28/2012
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