MEDICARE: DR. CARIN HANNA GRIBETZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	222165	NY

General Provider Information

NPI Number	:	1063549996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARIN HANNA GRIBETZ M.D.

Provider Business Mailing Address
First Line	:	151 EAST 85TH STREET,
Second Line	:	APT. 6E
City	:	NEW YORK
State	:	NY
Zip	:	10028-0208
Country	:	US
Telephone Number	:	212-996-8761
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 E 86TH ST
Second Line	:	SUITE 1N
City	:	NEW YORK
State	:	NY
Zip	:	10028-1024
Country	:	US
Telephone Number	:	212-289-3300
Fax Number	:	212-996-5707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/26/2010

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