Ibabao, Jairus Tesorero

Ibabao, Jairus Tesorero is an sole proprietor health care provider with primary practice located at 21 Porter Ave , Jamestown NY 14701-6247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Ibabao, Jairus Tesorero can be contacted via phone (716) 664-1909.

Contact Information

Primary practice address
21 Porter Ave Jamestown NY 14701-6247
Phone: (716) 664-1909
Fax: (716) 664-2214
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 193284 New York

Profile Details

NPI number 1568465458
LBN Legal business name Ibabao, Jairus Tesorero
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Mar 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568465458 NPPES
New York Other 714714 MVP
New York Other 005244934 MVP
New York Other 7200341 MVP
New York Other 830006548 MVP
New York Other 10352702 MVP
New York Other 0191329 MVP
New York Other 1294660001 MVP
New York MEDICAID 01830340 MVP

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