Provider Demographics
NPI:1235881152
Name:BARBARO, KATHERINE ELENA (DC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELENA
Last Name:BARBARO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 82ND PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2330
Mailing Address - Country:US
Mailing Address - Phone:347-543-8462
Mailing Address - Fax:
Practice Address - Street 1:7136 110TH ST STE SP1
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4873
Practice Address - Country:US
Practice Address - Phone:718-268-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty