Individual
PRATIMA DIBBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 E 65TH ST, NEW YORK, NY 10065-6701
(212) 223-0996
Mailing address
201 E 65TH ST, NEW YORK, NY 10065-6701
(212) 223-0996
(212) 249-7580
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
294323
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2014
Last updated
07/26/2022
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