Provider Demographics
NPI:1033116025
Name:LABOVE, NEIL (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:LABOVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 TOLLGATE ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4480
Mailing Address - Country:US
Mailing Address - Phone:401-738-2325
Mailing Address - Fax:
Practice Address - Street 1:176 TOLLGATE ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4480
Practice Address - Country:US
Practice Address - Phone:401-738-2325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI110452084N0400X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9021551Medicaid
B35508Medicare UPIN
RI9021551Medicaid