Provider Demographics
NPI:1124324124
Name:RIBOWSKY, SHIYA (RPA)
Entity type:Individual
Prefix:MR
First Name:SHIYA
Middle Name:
Last Name:RIBOWSKY
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1749
Mailing Address - Country:US
Mailing Address - Phone:516-248-0103
Mailing Address - Fax:516-248-4661
Practice Address - Street 1:350 OLD COUNTRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1749
Practice Address - Country:US
Practice Address - Phone:516-248-0103
Practice Address - Fax:516-248-4661
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY3773363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant