Provider Demographics
NPI:1134202641
Name:LABELSON, RAPHEL C (LAC)
Entity type:Individual
Prefix:MR
First Name:RAPHEL
Middle Name:C
Last Name:LABELSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WESTCHESTER PARK DRIVE
Mailing Address - Street 2:#325
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:914-517-8040
Mailing Address - Fax:914-948-5171
Practice Address - Street 1:244 WESTCHESTER AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2907
Practice Address - Country:US
Practice Address - Phone:914-948-7400
Practice Address - Fax:914-948-5171
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1402-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist