Healthcare Provider Details

I. General information

NPI: 1356522031
Provider Name (Legal Business Name): LUIS FRANCISCO LABRADOR RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SUNNYSIDE BLVD
PLAINVIEW NY
11803-1504
US

IV. Provider business mailing address

PO BOX 159
BARRINGTON NJ
08007-0159
US

V. Phone/Fax

Practice location:
  • Phone: 888-982-8594
  • Fax:
Mailing address:
  • Phone: 888-982-8594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number012239
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number012239
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: