Provider Demographics
NPI:1477518298
Name:BARNETT, JORDAN BIET (MD FACEP FAAEM FACHE)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:BIET
Last Name:BARNETT
Suffix:
Gender:M
Credentials:MD FACEP FAAEM FACHE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 S EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-2739
Practice Address - Country:US
Practice Address - Phone:180-084-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA63465261QU0200X, 207P00000X
PAMD055693L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA838191Medicaid
PA1531457Medicaid
NJ6849601Medicaid
PA1531457Medicaid
PAG06956Medicare UPIN
PA838191Medicaid
NJ6849601Medicaid