Provider Demographics
NPI:1235231614
Name:LABARBERA, ROSARIO J (DPM)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:J
Last Name:LABARBERA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026
Mailing Address - Country:US
Mailing Address - Phone:973-546-1616
Mailing Address - Fax:973-546-0023
Practice Address - Street 1:194 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026
Practice Address - Country:US
Practice Address - Phone:973-546-1616
Practice Address - Fax:973-546-0023
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00089000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ465 7770001OtherMEDICARE- DURABLE MED- EQ
NJ1593803Medicaid
NJ465 7770001OtherMEDICARE- DURABLE MED- EQ
LA 43166Medicare ID - Type Unspecified