Provider Demographics
NPI:1326142001
Name:DAVIES, BARBARA A (PA-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:DAVIES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 LOWER MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDES
Mailing Address - State:NY
Mailing Address - Zip Code:13731
Mailing Address - Country:US
Mailing Address - Phone:845-676-3663
Mailing Address - Fax:845-676-3665
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:845-676-3663
Practice Address - Fax:845-676-3665
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051782363AM0700X
NY005210-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005210-1OtherLICENSE
PAMA051782OtherLICENSE