Provider Demographics
NPI:1164608055
Name:THOMAS BARBARO D.P.M. P.C.
Entity Type:Organization
Organization Name:THOMAS BARBARO D.P.M. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBARO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-326-7979
Mailing Address - Street 1:706 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4513
Mailing Address - Country:US
Mailing Address - Phone:516-326-7979
Mailing Address - Fax:516-437-8588
Practice Address - Street 1:706 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4513
Practice Address - Country:US
Practice Address - Phone:516-326-7979
Practice Address - Fax:516-437-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004360213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP46511OtherBC/BS
NY15473AOtherGHI MEDICARE
NYIC1559OtherUNITED HEALTH CARE
NY01114507Medicaid
NY01114507Medicaid
NY4705210001Medicare NSC