Provider Demographics
NPI:1326057787
Name:BARKAN, ANATOLE (MD)
Entity Type:Individual
Prefix:MR
First Name:ANATOLE
Middle Name:
Last Name:BARKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 GRAVESEND NECK RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4428
Mailing Address - Country:US
Mailing Address - Phone:718-332-1405
Mailing Address - Fax:718-382-6319
Practice Address - Street 1:1503 GRAVESEND NECK RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4428
Practice Address - Country:US
Practice Address - Phone:718-332-1405
Practice Address - Fax:718-382-6319
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00992838Medicaid
NY796691Medicare ID - Type Unspecified
NY00992838Medicaid