Provider Demographics
NPI:1710315551
Name:LABRASCA PLASTIC SURGERY
Entity Type:Organization
Organization Name:LABRASCA PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALGIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LABRASCA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-371-7791
Mailing Address - Street 1:145 HOSPITAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1462
Mailing Address - Country:US
Mailing Address - Phone:814-371-7791
Mailing Address - Fax:814-371-7793
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-371-7791
Practice Address - Fax:814-371-7793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty