National Provider Identifier
Laura Susan Dibble, M.D.
Laura Susan Dibble, M.D. is listed in the NPPES registry with a primary specialty of Child & Adolescent Psychiatry Physician in Ithaca, NY and a listed phone number of (315) 253-9795.
Profile Overview
- NPI
- 1629085048
- Provider Type
- Individual
- Primary Specialty
- Child & Adolescent Psychiatry Physician
- Enumeration Date
- August 01, 2006
- Last Updated
- January 09, 2014
Practice Location
- 555 Warren RD
- Tst Boces
- Ithaca, NY 14850-1862
Phone: (315) 253-9795
Mailing Address
- PO Box 295
- Manlius, NY 13104-0295
Specialties
- Child & Adolescent Psychiatry Physician (2084P0804X)
- Psychiatry Physician (2084P0800X)
Full Record
- NPI
- 1629085048
- Entity Type
- Individual
- Last Name
- Dibble
- First Name
- Laura
- Middle Name
- Susan
- Credential
- M.D.
- Mailing Street Address
- PO Box 295
- Mailing City
- Manlius
- Mailing State
- NY
- Mailing ZIP Code
- 13104-0295
- Mailing Country
- US
- Mailing Phone
- (315) 420-3030
- Practice Street Address
- 555 Warren RD
- Practice Address Line 2
- Tst Boces
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1862
- Practice Country
- US
- Practice Phone
- (315) 253-9795
- Practice Fax
- (315) 253-3255
- Enumeration Date
- August 01, 2006
- Last Updated
- January 09, 2014
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Child & Adolescent Psychiatry Physician (2084P0804X), Psychiatry Physician (2084P0800X)