Provider Demographics
NPI:1053323592
Name:LABBATE, ANDREW JR (MSPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:LABBATE
Suffix:JR
Gender:M
Credentials:MSPT, ATC
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:LABBATE
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MSPT, ATC
Mailing Address - Street 1:333 EARLE OVINGTON BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3610
Mailing Address - Country:US
Mailing Address - Phone:516-321-2400
Mailing Address - Fax:516-321-2401
Practice Address - Street 1:2048 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3521
Practice Address - Country:US
Practice Address - Phone:718-252-0300
Practice Address - Fax:718-252-3619
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ31C41Medicare ID - Type Unspecified
NYQ4WFH1Medicare PIN