Individual
DR. SUZY BIBAWY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
75 VANDERBILT AVE, STATEN ISLAND, NY 10304-2604
(718) 818-6000
Mailing address
86 MICHAEL LOOP, STATEN ISLAND, NY 10301-4639
(718) 818-5584
(718) 818-6066
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
210720
NY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
210720
NY
Other
Enumeration date
08/01/2006
Last updated
11/03/2015
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