Individual
ANDREA T LABORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 1 GROUND WHITE BLDG, PHILADELPHIA, PA 19104
(215) 662-3261
Mailing address
3624 MARKET STREET, STE 560W UPHS OFFICE OF MEDICAL AFFAIRS, PHILADELPHIA, PA 19104
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD045388E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012404960005
—
PA
Enumeration date
06/06/2006
Last updated
08/28/2008
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