Provider Demographics
NPI:1518007780
Name:BARBATO, MARCIE KAY (NP)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:KAY
Last Name:BARBATO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARCIE
Other - Middle Name:KAY
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:5102 BLACK HAWK CIR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5429
Mailing Address - Country:US
Mailing Address - Phone:315-806-0950
Mailing Address - Fax:
Practice Address - Street 1:5102 BLACK HAWK CIR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5429
Practice Address - Country:US
Practice Address - Phone:315-806-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334503363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15187780OtherNPI