Provider Demographics
NPI:1093865511
Name:RIBAS, MICHELE (LPN)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:RIBAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEPEW RD
Mailing Address - Street 2:
Mailing Address - City:HIGH FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12440-5602
Mailing Address - Country:US
Mailing Address - Phone:845-687-9568
Mailing Address - Fax:
Practice Address - Street 1:16 DEPEW RD
Practice Address - Street 2:
Practice Address - City:HIGH FALLS
Practice Address - State:NY
Practice Address - Zip Code:12440-5602
Practice Address - Country:US
Practice Address - Phone:845-687-9568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249869-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02735326Medicaid