MEDICARE: MRS. LABINSKY ROACH FALAH

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
1	174400000X	Specialist	3500	NY

General Provider Information

NPI Number	:	1376804328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LABINSKY ROACH FALAH

Provider Business Mailing Address
First Line	:	2 HAVEN PLZ
Second Line	:	APT #6B
City	:	NEW YORK
State	:	NY
Zip	:	10009-3922
Country	:	US
Telephone Number	:	347-678-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HAVEN PLZ
Second Line	:	APT #6B
City	:	NEW YORK
State	:	NY
Zip	:	10009-3922
Country	:	US
Telephone Number	:	347-678-0009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	06/06/2012

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