Provider Demographics
NPI:1023004926
Name:LABANCA, KARIN WILLIAMS (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:WILLIAMS
Last Name:LABANCA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:KARIN
Other - Middle Name:MICHELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 PAUGUSSETT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1503
Mailing Address - Country:US
Mailing Address - Phone:203-947-2849
Mailing Address - Fax:
Practice Address - Street 1:141 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1438
Practice Address - Country:US
Practice Address - Phone:203-270-2977
Practice Address - Fax:203-841-1245
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014584-1225100000X
CT006688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0402615OtherAETNA
CT080006688CT05OtherANTHEM
CT776575OtherOPTUM- UNITED HEALTH CARE
CT0402615OtherCIGNA
CT22740111960Medicare PIN