Provider Demographics
NPI:1235314824
Name:JOSE L BARRIOCANAL, MD PA
Entity Type:Organization
Organization Name:JOSE L BARRIOCANAL, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARRIOCANAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-629-4528
Mailing Address - Street 1:220 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3820
Mailing Address - Country:US
Mailing Address - Phone:302-629-4528
Mailing Address - Fax:302-629-6533
Practice Address - Street 1:220 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3820
Practice Address - Country:US
Practice Address - Phone:302-629-4528
Practice Address - Fax:302-629-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0686050001Medicare NSC