Provider Demographics
NPI:1508917873
Name:MEDLIN, BARBARA (NP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:MEDLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WHITAKER AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-3027
Mailing Address - Country:US
Mailing Address - Phone:201-650-4224
Mailing Address - Fax:973-684-0324
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE #610
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:201-650-4224
Practice Address - Fax:973-684-0324
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400882363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health