Provider Demographics
NPI:1235278664
Name:BAROUH, DAVID (LMT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BAROUH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 E 5TH ST
Mailing Address - Street 2:APT 5N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4678
Mailing Address - Country:US
Mailing Address - Phone:718-338-9304
Mailing Address - Fax:
Practice Address - Street 1:1350 E 5TH ST
Practice Address - Street 2:APT 5N
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4678
Practice Address - Country:US
Practice Address - Phone:718-338-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004311247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other