Provider Demographics
NPI:1235401191
Name:BARKAN, NICOLE (CPNP AC/PC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BARKAN
Suffix:
Gender:F
Credentials:CPNP AC/PC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:KURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP AC/PC
Mailing Address - Street 1:1275 YORK AVENUE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVENUE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-639-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382217363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics