Provider Demographics
NPI:1578518114
Name:LABRUNA, VINCENT FRANCES (DPM)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:FRANCES
Last Name:LABRUNA
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 1:43 YAWPO AVE
Mailing Address - Street 2:11
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2717
Mailing Address - Country:US
Mailing Address - Phone:201-337-5150
Mailing Address - Fax:973-761-7449
Practice Address - Street 1:43 YAWPO AVE
Practice Address - Street 2:11
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2717
Practice Address - Country:US
Practice Address - Phone:201-337-5150
Practice Address - Fax:973-761-7449
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01612213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1260600Medicaid
T45163Medicare UPIN
NJ1260600Medicaid