Provider Demographics
NPI:1558462366
Name:BARTON, JANET M (FNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:BARTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CLARK PL
Mailing Address - Street 2:OLD STONE BLDG
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541
Mailing Address - Country:US
Mailing Address - Phone:845-621-2211
Mailing Address - Fax:845-621-4528
Practice Address - Street 1:21 CLARK PL
Practice Address - Street 2:OLD STONE BLDG
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541
Practice Address - Country:US
Practice Address - Phone:845-621-2211
Practice Address - Fax:845-621-4528
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3335961363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02299232Medicaid
P00244388OtherPALMETTO GBA
2E80310OtherBCBS
2E80310Medicare ID - Type Unspecified
P00244388OtherPALMETTO GBA