Physician Compare National (NPI:1780618363)

HEALTHCARE PROVIDER: GARY J LABIANCO DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1780618363
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244396398
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120613000706
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LABIANCO
	Individual professional last name
Provider First Name	GARY
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5676 FAR HILLS AVE
	Group Practice or individual's line 1 address
City	DAYTON
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	454292206
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360079
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KETTERING MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360133
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GRANDVIEW AND SOUTHVIEW HOSPITALS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y