Provider Demographics
NPI:1831640457
Name:LABUSKES, CRAIG M (PA-C)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:M
Last Name:LABUSKES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8105 ADAMS DR STE A
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8625
Mailing Address - Country:US
Mailing Address - Phone:717-652-1211
Mailing Address - Fax:717-652-4948
Practice Address - Street 1:5400 CHAMBERS HILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2545
Practice Address - Country:US
Practice Address - Phone:717-564-5400
Practice Address - Fax:717-564-7859
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA058365363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103226514Medicaid