Provider Demographics
NPI:1033217435
Name:BARTH, ABRAHAM EDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:EDDY
Last Name:BARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SCHOOL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2547
Mailing Address - Country:US
Mailing Address - Phone:516-674-0404
Mailing Address - Fax:
Practice Address - Street 1:58 SCHOOL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2547
Practice Address - Country:US
Practice Address - Phone:516-674-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157224207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology