Provider Demographics
NPI:1003151101
Name:IBALE, CAROLINE PAULIN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:PAULIN
Last Name:IBALE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 E 72ND ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5816
Mailing Address - Country:US
Mailing Address - Phone:347-820-1410
Mailing Address - Fax:
Practice Address - Street 1:1207 E 72ND ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5816
Practice Address - Country:US
Practice Address - Phone:347-820-1410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY568986163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse