Provider Demographics
NPI:1093776239
Name:LIGHT, BARBARA (DO)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:LIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 OGLETOWN STANTON RD
Mailing Address - Street 2:MAP 2 SUITE 1116
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2072
Mailing Address - Country:US
Mailing Address - Phone:302-368-8612
Mailing Address - Fax:
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:MAP 2 SUITE 1116
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2072
Practice Address - Country:US
Practice Address - Phone:302-368-8612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0006575208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE180061OtherCOVENTRY HEALTH CARE
DE7010364OtherAETNA USHC
DEH72664OtherMID ATLANTIC HEALTH CARE
DE1425271OtherAMERIHEALTH - PPO
DE1000015432Medicaid
DE1000015432OtherDELAWARE PHYSICIANS CARE
DE1000015432OtherDIAMOND STATE HEALTH CARE
DE615622-02OtherBC/BS MD PCP #
DE2110792000OtherAMERIHEALTH - HMO
DE262908OtherMAMSI
DEH72664OtherBC/BS DE PCP #
DE2110792000OtherKEYSTONE EAST HMO (SEE AM
DE491363Medicare ID - Type Unspecified
DE2110792000OtherKEYSTONE EAST HMO (SEE AM