Provider Demographics
NPI:1881427607
Name:FIBLEUIL, MICAELA
Entity type:Individual
Prefix:
First Name:MICAELA
Middle Name:
Last Name:FIBLEUIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MEYER RD APT 101
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1007
Mailing Address - Country:US
Mailing Address - Phone:516-366-7567
Mailing Address - Fax:
Practice Address - Street 1:90 MEYER RD APT 101
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14226-1007
Practice Address - Country:US
Practice Address - Phone:516-366-7567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program