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NPI Code Detail

MEDICARE: KRISTINA D LABONTE P.A.-C

MEDICARE:   KRISTINA D LABONTE  P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant001520CT
2363A00000XPhysician Assistant1520CT

General Provider Information

NPI Number : 1699786582
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA D LABONTE P.A.-C
Provider Business Mailing Address
First Line : 67 MAPLE AVE
Second Line :
City : DERBY
State : CT
Zip : 06418-1328
Country : US
Telephone Number : 203-732-7325
Fax Number :
Provider Business Practice Location Address
First Line : 135 DIVISION ST STE 2
Second Line :
City : ANSONIA
State : CT
Zip : 06401-2135
Country : US
Telephone Number : 203-308-2705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 05/11/2022

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Directions to “ KRISTINA D LABONTE P.A.-C” Practice Location

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