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NPI Code Detail

MEDICARE: DAVID IBRAGIMOV

MEDICARE: DAVID IBRAGIMOV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist063327-01NY

General Provider Information

NPI Number : 1992449185
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID IBRAGIMOV
Provider Business Mailing Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 718-920-4321
Fax Number :
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 718-920-4321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2022
Last Update Date : 12/10/2025

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Directions to “ DAVID IBRAGIMOV ” Practice Location

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