Provider Demographics
NPI:1437216488
Name:LIIMAKKA, BARRY (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:
Last Name:LIIMAKKA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 US RT 130 N
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077
Mailing Address - Country:US
Mailing Address - Phone:856-829-9345
Mailing Address - Fax:856-829-0580
Practice Address - Street 1:218A SUNSET RD
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1110
Practice Address - Country:US
Practice Address - Phone:609-835-2900
Practice Address - Fax:856-829-0580
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR04299300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse