1235113036 NPI number — DR. OSCAR LABORDA M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235113036 NPI number — DR. OSCAR LABORDA M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LABORDA

Provider First Name:

OSCAR

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1235113036

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/29/2010

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 350

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SELLERSVILLE

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

18960-0350

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

215-723-2333

Provider Business Mailing Address Fax Number:

215-723-9112

Provider First Line Business Practice Location Address:

1088 W BALTIMORE PIKE

Provider Second Line Business Practice Location Address:

SUITE 2407

Provider Business Practice Location Address City Name:

MEDIA

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

19063

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

610-565-1808

Provider Business Practice Location Address Fax Number:

610-892-9535

Provider Enumeration Date:

12/05/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RG0100X , with the licence number:  MD016384E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 00000315032 06 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0000673779 . This is a "BOEING BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0031422000 . This is a "KEYSTONE HEALTHPLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1334935 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0030907 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0031422000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0000161491 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0000673779 . This is a "HORIZON BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0000161491 . This is a "BLAIR MILL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0007274050003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0031422000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".