Provider Demographics
NPI:1184632028
Name:LABARBERA, PETER T (DPM)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:T
Last Name:LABARBERA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-754-0879
Mailing Address - Fax:203-757-4123
Practice Address - Street 1:389 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-754-0879
Practice Address - Fax:203-757-4123
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00105213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
9576547004OtherCIGNA
95922OtherAETNA US HEALTHCARE
OV7802OtherHEALTH NET
782531OtherCONNECTICARE
CT030000105CT01OtherBS
NHS346OtherOXFORD HEALTH PLANS
T23496Medicare UPIN
CTC00898Medicare PIN