Provider Demographics
NPI:1093254773
Name:CEARLEY, BARBARA (RN, RDH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CEARLEY
Suffix:
Gender:F
Credentials:RN, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 ELK ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2707
Mailing Address - Country:US
Mailing Address - Phone:518-475-6608
Mailing Address - Fax:
Practice Address - Street 1:395 ELK ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2707
Practice Address - Country:US
Practice Address - Phone:518-475-6608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY465575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse