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Individual

EPHRAIM BIBLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
269 F EAST MAIN STREET, SMITHTOWN, NY 11787-2322
(631) 265-8300
Mailing address
63 KRISTIN LN, HAUPPAUGE, NY 11788-1235
(631) 724-5262

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3960
NY

Other

Enumeration date
06/22/2006
Last updated
07/08/2007
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