Organization
TUBMAN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INNA TUBMAN M.D. (PHYSICIAN)
(917) 862-4218
Entity
Organization
Contact information
Practice address
78 CROMWELL AVE, STATEN ISLAND, NY 10304-3912
(718) 987-9175
Mailing address
100 JOLINE AVE, STATEN ISLAND, NY 10307-2019
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
240622
NY
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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