Individual
SANDY IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
1 CAMPUS RD, STATEN ISLAND, NY 10301-4479
(917) 273-2041
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
028548
NY
Other
Enumeration date
04/30/2022
Last updated
07/29/2022
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