Organization
INTERPUBLIC MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOURDES I PUBLICO (MEDICAL DOCTOR)
(718) 690-4237
Entity
Organization
Contact information
Practice address
1005 RICHMOND RD, STATEN ISLAND, NY 10304-2413
(718) 690-4237
Mailing address
PO BOX 520391, FLUSHING, NY 11352-0391
(718) 690-4237
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
184001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01934192
—
NY
Enumeration date
11/06/2009
Last updated
11/06/2009
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