Provider Demographics
NPI:1598962524
Name:LABADY, LILIANA (PT)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:LABADY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17233 N HOLMES BLVD
Mailing Address - Street 2:STE 1650
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-2030
Mailing Address - Country:US
Mailing Address - Phone:602-547-1836
Mailing Address - Fax:602-547-2806
Practice Address - Street 1:601 W MAHONE DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-2046
Practice Address - Country:US
Practice Address - Phone:575-746-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32283225100000X
NM0717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM65608739Medicaid
NM65608739Medicaid