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General NPI Number Information
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NPI Number | 1972588564
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL TIBALDI M.D.,F.A.C.P.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 17415 HORACE HARDING EXPY FL 2
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1527
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Country | US
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Telephone | 718-762-3111
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Fax | 718-353-6315
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Provider Business Mailing Address
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Address Line | 17415 HORACE HARDING EXPY FL 2
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1527
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Country | US
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Telephone | 718-762-3111
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Fax | 718-353-6315
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 144862
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | AT1048188
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License Number State | NY
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