Basic Information
Provider Information
NPI: 1457734568
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LABUZETTA
FirstName: MICHAEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1555 LONG POND RD
Address2: DEPT OF MEDICINE
City: ROCHESTER
State: NY
PostalCode: 146264122
CountryCode: US
TelephoneNumber: 5857237870
FaxNumber: 5857237871
Practice Location
Address1: 1555 LONG POND RD
Address2:  
City: ROCHESTER
State: NY
PostalCode: 14626
CountryCode: US
TelephoneNumber: 5857237769
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/07/2015
LastUpdateDate: 07/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X294835NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X294835NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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