Most Relevant Information
Provider Data
| NPI Number: | 1003493073 |
| Provider Name: | JUDE TABBA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/25/2021 |
| Last Updated: | 03/25/2021 |
Provider Practice Location
4802 10TH AVE
BROOKLYN
NY
112192916
Practice Location Phone/Fax
| Phone: | 7812836000 |
| Fax: |
Provider Mailing Location
4802 10TH AVE
BROOKLYN
NY
112192916
Provider Mailing Phone/Fax
| Phone: | 7812836000 |
| Fax: |