Laurence A Sibrack, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

017539 Issued in CT

Practice address

170 Mount Pleasant Rd Ste 201
Newtown, CT 06470-1408

Phone

(203) 792-4151

Fax

(203) 792-4155

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Naples Center for Dermatology & Riverchase Dermatology

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1538645775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1396740643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MOUNT PLEASANT RD",
            "address_2": "STE 201",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701408",
            "telephone_number": "203-792-4151",
            "fax_number": "203-792-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MOUNT PLEASANT RD STE 201",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701408",
            "telephone_number": "203-792-4151",
            "fax_number": "203-792-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBRACK",
        "first_name": "LAURENCE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "017539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001175397",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Leigh Schear, LCSW
• Della Schmid, D.C.
• Elizabeth G Scholl
• Cheryl R Schwartz, LCSW
• Melissa Serafini, LPC
• Monica Ann Sievel, LPC
• Elizabeth Abbey Lynn Silva, DPT
• Kristie Uniacke Simmons, MS, RD, CEDS-C
• Amy Singer, LCSW
• Sleep Connecticut PLLC

• Dermatology Physician in Newtown, CT
• Providers in Newtown, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.