Basic Information
| Provider Information | |||||||||
| NPI: | 1851623847 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IBLE | ||||||||
| FirstName: | CLAUDETTE | ||||||||
| MiddleName: | DENISE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | IBLE | ||||||||
| OtherFirstName: | CLAUDETTE | ||||||||
| OtherMiddleName: | DENISE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LMSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 17 W 182ND ST | ||||||||
| Address2: | APT 2J | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104531727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183643186 | ||||||||
| FaxNumber: | 7185795310 | ||||||||
| Practice Location | |||||||||
| Address1: | 234 E 149TH ST | ||||||||
| Address2: | SOCIAL WORK OFFICE 1B2 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104515504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185795657 | ||||||||
| FaxNumber: | 7185795310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2010 | ||||||||
| LastUpdateDate: | 02/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 070347 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.