Provider Demographics
NPI:1154321776
Name:BARNA, NICHOLAS J (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:BARNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1060 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1444
Mailing Address - Country:US
Mailing Address - Phone:570-459-9923
Mailing Address - Fax:570-459-9923
Practice Address - Street 1:1060 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1444
Practice Address - Country:US
Practice Address - Phone:570-459-9927
Practice Address - Fax:570-459-9923
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038232E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011660580003Medicaid
PA0011660580003Medicaid
PA430099Medicare ID - Type Unspecified