Provider Demographics
NPI:1780684373
Name:LABINER, BARTLEY R (DDS)
Entity type:Individual
Prefix:
First Name:BARTLEY
Middle Name:R
Last Name:LABINER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5221
Mailing Address - Country:US
Mailing Address - Phone:718-583-6347
Mailing Address - Fax:718-583-8047
Practice Address - Street 1:1940 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5221
Practice Address - Country:US
Practice Address - Phone:718-583-6347
Practice Address - Fax:718-583-8047
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0318751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00297287Medicaid