Provider Demographics
NPI:1003919200
Name:BARBER, THOMAS ANDREW (PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANDREW
Last Name:BARBER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 59 PUBLIC SQ
Mailing Address - Street 2:WOODRUFF PROFF BLDG
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601
Mailing Address - Country:US
Mailing Address - Phone:315-782-7872
Mailing Address - Fax:315-782-7871
Practice Address - Street 1:53 59 PUBLIC SQ
Practice Address - Street 2:WOODRUFF PROFF BLDG
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601
Practice Address - Country:US
Practice Address - Phone:315-782-7872
Practice Address - Fax:315-782-7871
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56468AMedicare ID - Type Unspecified