1407286370 NPI number — BARBA FAMILY DENTAL LLC

Table of content: MARY RACHEL MCGUFFEY M.D. (NPI 1235157645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407286370 NPI number — BARBA FAMILY DENTAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBA FAMILY DENTAL LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407286370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 MIDLAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07026-1665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-767-2980
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 MIDLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07026-1665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-767-2980
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARBAGELATA
Authorized Official First Name:
NALDO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DENTIST
Authorized Official Telephone Number:
973-767-2980

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  22D102548300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)