Individual
GREG RIBAKOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-7686
(718) 283-7392
Mailing address
PO BOX 30060, NEW YORK, NY 10087-0060
(718) 283-7686
(718) 283-7392
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
152786
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
152786
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01080244
—
NY
01
—
A400025191
MEDICARE PTAN
NY
Enumeration date
09/20/2005
Last updated
02/24/2014
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