Healthcare Provider Details
I. General information
NPI: 1407225576
Provider Name (Legal Business Name): MURIEL BIBELY GARCIA ROSARIO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/18/2015
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
135 HAVEN AVENUE
NEW YORK NY
10032
US
IV. Provider business mailing address
120 AVE LA SIERRA APTO E5202 CONDOMINIO LA SIERRA DEL MONTE
SAN JUAN PR
00926
US
V. Phone/Fax
- Phone: 862-316-4740
- Fax:
- Phone: 787-404-1613
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282NC2000X |
| Taxonomy | Children's Hospital |
| License Number | 32,169-R |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 294956 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: