Provider Demographics
NPI:1639210628
Name:LABIAK-MAHER, CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LABIAK-MAHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-1351
Mailing Address - Country:US
Mailing Address - Phone:401-848-0008
Mailing Address - Fax:401-816-5802
Practice Address - Street 1:625 MAIN RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-1351
Practice Address - Country:US
Practice Address - Phone:401-848-0008
Practice Address - Fax:401-816-5802
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD71132080P0006X
RIMD071132080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics