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General NPI Number Information
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NPI Number | 1023439288
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Entity Type | Organization
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Legal Business Name | FIBRE, LLC
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 5 PENN PLZ FL 23
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City | NEW YORK
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State | NY
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Zip | 10001-1810
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Country | US
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Telephone | 914-236-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 5 PENN PLZ FL 23
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City | NEW YORK
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State | NY
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Zip | 10001-1810
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Country | US
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Telephone | 914-236-4367
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | EGYPT LAWSON
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Credential | PHD
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Telephone | 914-236-4367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 4442560
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License Number State | NY
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