Sibrack, Laurence A

Sibrack, Laurence A is an individual health care provider with primary practice located at 170 Mount Pleasant Rd Ste 201 , Newtown CT 06470-1408. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Sibrack, Laurence A can be contacted via phone (203) 792-4151.

Contact Information

Primary practice address
170 Mount Pleasant Rd Ste 201 Newtown CT 06470-1408
Phone: (203) 792-4151
Fax: (203) 792-4155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 017539 Connecticut

Profile Details

NPI number 1396740643
LBN Legal business name Sibrack, Laurence A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated May 23rd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396740643 NPPES
Connecticut MEDICAID 001175397

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