Provider Demographics
NPI:1003923111
Name:LABRIOLA, PAULA A (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:LABRIOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:LABRIOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1924 OPITZ BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:703-494-1144
Mailing Address - Fax:703-494-5647
Practice Address - Street 1:1924 OPITZ BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:703-494-1144
Practice Address - Fax:703-494-5647
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049273208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6713122Medicaid
VA6713122Medicaid