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General NPI Number Information
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NPI Number | 1346064334
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Entity Type | Individual
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Provider Name | COLLIN STEVEN LABOMBARD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 4 COMMERCE LN
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City | CANTON
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State | NY
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Zip | 13617-3739
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Country | US
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Telephone | 315-379-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 62 W HIGH ST
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City | NORFOLK
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State | NY
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Zip | 13667-3101
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Country | US
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Telephone | 518-593-4904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 013382-01
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License Number State | NY
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