MEDICARE: LABRIOLAS INTEGRATIVE HEALTH PC

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1952056855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABRIOLAS INTEGRATIVE HEALTH PC

Provider Business Mailing Address
First Line	:	PO BOX 6316
Second Line	:
City	:	HERMITAGE
State	:	PA
Zip	:	16148-0924
Country	:	US
Telephone Number	:	412-782-6800
Fax Number	:	412-782-6800

Provider Business Practice Location Address
First Line	:	30 HIGH ST
Second Line	:
City	:	ETNA
State	:	PA
Zip	:	15223-1954
Country	:	US
Telephone Number	:	412-782-6800
Fax Number	:	412-782-6800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUZANNE M LABRIOLA
Credential	:	D.O.
Telephone Number	:	412-782-6800

Provider Enumeration Date	:	02/18/2022
Last Update Date	:	02/18/2022

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