Individual
ANDREW IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 MERRICK AVE, EAST MEADOW, NY 11554-2200
(516) 308-9244
Mailing address
35 NEWCASTLE AVE, PLAINVIEW, NY 11803-2705
(516) 652-5956
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061190-01
NY
Other
Enumeration date
05/14/2019
Last updated
09/18/2021
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