Provider Demographics
NPI:1609694827
Name:IMBERT, CLAUDIA VICTORIA (MD)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:VICTORIA
Last Name:IMBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 HENRY HUDSON PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3217
Mailing Address - Country:US
Mailing Address - Phone:917-892-6309
Mailing Address - Fax:
Practice Address - Street 1:3036 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5733
Practice Address - Country:US
Practice Address - Phone:718-823-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY900B174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty