Provider Demographics
NPI:1205822459
Name:REALE, BARBARA J (CNM)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:REALE
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:100 CENTREX
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-662-2730
Mailing Address - Fax:908-788-6483
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:100 CENTREX
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-2730
Practice Address - Fax:908-788-6483
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00015301176B00000X, 367A00000X
PAMW010024367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB16131Medicare UPIN