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Provider Information for 1700844735

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. BRIAN IAN LABOW

Gender: MALE

Individual NPI: 1700844735

Calendar   Last Updated:  2008-06-18
  Certification Date: 

Details

Name Value
NPI 1700844735
Enumeration Date 2006-05-01
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE HUN 158
BOSTON, MA 02115-5724
United States

Phone: 617-355-4964 | Fax: 617-738-1657
View Map External Link
Primary Practice Address 300 LONGWOOD AVE HUN 158
BOSTON, MA 02115-5724
United States

Phone: 617-355-4964 | Fax: 617-738-1657
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3157253
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2086S0122X - Surgery Plastic and Reconstructive Surgery MA 150910