Provider Demographics
NPI:1043235393
Name:LIVINGSTON, BARBARA ELLEN (RN, NP, AOCNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RN, NP, AOCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6914
Mailing Address - Country:US
Mailing Address - Phone:631-427-6060
Mailing Address - Fax:631-549-4858
Practice Address - Street 1:347 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6914
Practice Address - Country:US
Practice Address - Phone:631-427-6060
Practice Address - Fax:631-549-4858
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301306363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP48141Medicare UPIN
NY2E5161Medicare ID - Type Unspecified