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General NPI Number Information
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NPI Number | 1720536287
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Entity Type | Individual
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Provider Name | ROSE SONA BRIGHT JIBU NP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 11 WINDSOR ST HICKSVILLE
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City | HICKSVILLE
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State | NY
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Zip | 11801-2357
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Country | US
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Telephone | 516-216-5189
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 GRAND CONCOURSE BRONX LEBANON HOSPITAL CENTER
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-239-8389
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Fax | 718-239-8360
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 382662
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License Number State | NY
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