Organization
JOSEPH LABRICCIOSA D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH LABRICCIOSA D.O. (OWNER)
(610) 353-5840
Entity
Organization
Contact information
Practice address
1999 SPROUL RD, SUITE 21, BROOMALL, PA 19008-3508
(610) 353-5840
(610) 353-3420
Mailing address
1999 SPROUL RD, SUITE 21, BROOMALL, PA 19008-3508
(610) 353-5840
(610) 353-3420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1646455
GROUP BLUE SHIELD
—
01
—
2324238001
GROUP KEYSTONE
—
Enumeration date
06/16/2008
Last updated
05/08/2013
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