Provider Demographics
NPI:1831275015
Name:SIBERIO, OSCAR JUAN (MD)
Entity type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:JUAN
Last Name:SIBERIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3311 86TH STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1535
Mailing Address - Country:US
Mailing Address - Phone:718-424-9407
Mailing Address - Fax:718-424-9812
Practice Address - Street 1:3311 86TH STREET
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1535
Practice Address - Country:US
Practice Address - Phone:718-424-9407
Practice Address - Fax:718-424-9812
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY139452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00430093Medicaid
D83444Medicare UPIN
NY00430093Medicaid