Healthcare Provider Details

I. General information

NPI: 1477498269
Provider Name (Legal Business Name): IBRAHIM BABA MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRONX-LEBANON HOSPITAL CENTER 1650 GRAND CONCOURSE
BRONX NY
10457
US

IV. Provider business mailing address

BRONX-LEBANON HOSPITAL CENTER 1650 GRAND CONCOURSE
BRONX NY
10457
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-8203
  • Fax: 718-901-8704
Mailing address:
  • Phone: 646-740-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: