Provider Demographics
NPI:1508128463
Name:PORRINI, BARBARA ANN
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:PORRINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DENIS LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1513
Mailing Address - Country:US
Mailing Address - Phone:631-513-6374
Mailing Address - Fax:
Practice Address - Street 1:15 DENIS LN
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1513
Practice Address - Country:US
Practice Address - Phone:631-513-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048130011174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist