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Individual

DR. IRENE G IBANEZ-MANLAPAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-5962
Mailing address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-5962

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
07991R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1069922
CIGNA
01
11-00103
UNITED HEALTHCARE
LA
05
1100170
LA
05
1441996
LA
01
220012016
PALMETTO GBA - RRMC
LA
01
721134010
TRICARE
LA
01
721134010B
HUMANA
LA
Enumeration date
11/08/2005
Last updated
04/04/2012
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