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NPI 1639629611

NPI 1639629611 : ARTA LJUBANOVIC AU.D. : STATEN ISLAND, NY

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General NPI Number Information
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    NPI Number           |    1639629611
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    Entity Type          |    Individual 
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    Provider Name        |    ARTA LJUBANOVIC AU.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/13/2016
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    Last Update Date     |    06/05/2020
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Provider Practice Location Address
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    Address Line         |    378 SEAVIEW AVE 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10305-2200
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    Country              |    US
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    Telephone            |    718-226-9429
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    378 SEAVIEW AVE 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10305-2200
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    Country              |    US
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    Telephone            |    718-226-9429
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    002663-1
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    License Number State |    NY
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