Provider Demographics
NPI:1245593789
Name:BARRY, ALLAN R (RN)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:R
Last Name:BARRY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROUNDABOUT RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1823
Mailing Address - Country:US
Mailing Address - Phone:631-361-2112
Mailing Address - Fax:
Practice Address - Street 1:8 ROUNDABOUT RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1823
Practice Address - Country:US
Practice Address - Phone:631-361-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY634532163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health