Provider Demographics
NPI:1528536141
Name:IBANEZ-CASAS, INMACULADA
Entity type:Individual
Prefix:DR
First Name:INMACULADA
Middle Name:
Last Name:IBANEZ-CASAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 SAILLY AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1729
Mailing Address - Country:US
Mailing Address - Phone:910-260-3090
Mailing Address - Fax:
Practice Address - Street 1:SIBLEY HALL
Practice Address - Street 2:113 RUGAR STREET
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-564-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician