1821496654 NPI number — MRS. STEPHANIE ANN BARBATO CNP

Table of content: MRS. STEPHANIE ANN BARBATO CNP (NPI 1821496654)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821496654 NPI number — MRS. STEPHANIE ANN BARBATO CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARBATO
Provider First Name:
STEPHANIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

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:
1821496654
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2163
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOUNGSTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44504-0163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-744-4369
Provider Business Mailing Address Fax Number:
330-744-1728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
540 PARMALEE AVE
Provider Second Line Business Practice Location Address:
SUITE # 610
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44510-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-744-4369
Provider Business Practice Location Address Fax Number:
330-744-1728
Provider Enumeration Date:
12/10/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  16683 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PENDING , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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