Provider Demographics
NPI:1033653944
Name:LABIANCO, SCOTT STEVEN (BOCPD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:STEVEN
Last Name:LABIANCO
Suffix:
Gender:M
Credentials:BOCPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 TURNPIKE DR
Mailing Address - Street 2:UNIT ONE
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1830
Mailing Address - Country:US
Mailing Address - Phone:203-758-8307
Mailing Address - Fax:203-758-7879
Practice Address - Street 1:80 TURNPIKE DR
Practice Address - Street 2:UNIT ONE
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1830
Practice Address - Country:US
Practice Address - Phone:203-758-8307
Practice Address - Fax:203-758-7879
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC50216224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist