Individual
DR. SYED T. IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-5500
(570) 621-5077
Mailing address
2407 CAMBRIDGE CIR, HATFIELD, PA 19440-1491
(570) 621-5500
(570) 621-5077
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
MD444758
PA
2084P0800X
Psychiatry Physician
222749
NY
2084P0800X
Psychiatry Physician
Primary
MD444758
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02499585
—
NY
Enumeration date
10/04/2006
Last updated
01/19/2017
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