Individual
JOHN IBIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16101 89TH AVE, JAMAICA, NY 11432-3902
(718) 262-8190
(718) 739-4331
Mailing address
16101 89TH AVE, JAMAICA, NY 11432-3902
(718) 262-8190
(718) 739-4331
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/05/2011
Last updated
09/05/2011
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