Provider Demographics
NPI:1891933537
Name:LABARDY, SHIRLEY
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:
Last Name:LABARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22514 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1727
Mailing Address - Country:US
Mailing Address - Phone:718-528-0960
Mailing Address - Fax:718-528-3522
Practice Address - Street 1:25302 147TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2541
Practice Address - Country:US
Practice Address - Phone:718-528-0960
Practice Address - Fax:718-528-3522
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005293213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP6665OtherEMPIRE BLUE CROSS BLUE SHIELD
NYP66651OtherEMPIRE MEDICARE