Individual
LJUBISA MICIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2604 169TH ST, FLUSHING, NY 11358-1131
(347) 438-1950
(347) 438-1951
Mailing address
2604 169TH ST, FLUSHING, NY 11358-1131
(347) 438-1950
(347) 438-1951
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
212787
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01894586
—
NY
Enumeration date
07/29/2006
Last updated
05/09/2013
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