Provider Demographics
NPI:1447763990
Name:BUCKINGHAM, BARBARA (LPN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BUCKINGHAM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 JAMES ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2392
Mailing Address - Country:US
Mailing Address - Phone:315-437-4500
Mailing Address - Fax:315-437-1632
Practice Address - Street 1:3300 JAMES ST STE 201
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2392
Practice Address - Country:US
Practice Address - Phone:315-437-4500
Practice Address - Fax:315-437-1632
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330002164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse