Provider Demographics
NPI:1710060116
Name:LABES, BABAOFF, BANOONI AND EISENBERG, P.C.
Entity Type:Organization
Organization Name:LABES, BABAOFF, BANOONI AND EISENBERG, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:BANOONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-489-1070
Mailing Address - Street 1:28555 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2973
Mailing Address - Country:US
Mailing Address - Phone:248-489-1070
Mailing Address - Fax:248-489-0850
Practice Address - Street 1:28555 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2973
Practice Address - Country:US
Practice Address - Phone:248-489-1070
Practice Address - Fax:248-489-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM85190Medicare ID - Type UnspecifiedMEDICARE GROUP ID