Basic Information
| Provider Information | |||||||||
| NPI: | 1518292325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRY | ||||||||
| FirstName: | BERNADETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 BEAR TAVERN RD | ||||||||
| Address2: | |||||||||
| City: | EWING | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086281020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003703651 | ||||||||
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| Practice Location | |||||||||
| Address1: | 39 BARBARA DR | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078694143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3472626299 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2009 | ||||||||
| LastUpdateDate: | 06/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | NP9598 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2200X | 26NJ00367600 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.