Provider Demographics
NPI:1346324027
Name:LANDRETH, BARBARA HORAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:HORAN
Last Name:LANDRETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:115 E 67TH ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5951
Mailing Address - Country:US
Mailing Address - Phone:212-772-7569
Mailing Address - Fax:212-327-4966
Practice Address - Street 1:115 E 67TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5951
Practice Address - Country:US
Practice Address - Phone:212-772-7569
Practice Address - Fax:212-327-4966
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY175460208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY175460OtherLICENSE