Provider Demographics
NPI:1558647990
Name:ADZAKU, BARBARA (LPN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:ADZAKU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ALCOTT PL APT 2C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4347
Mailing Address - Country:US
Mailing Address - Phone:347-602-8788
Mailing Address - Fax:
Practice Address - Street 1:140 ALCOTT PL APT 2C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4347
Practice Address - Country:US
Practice Address - Phone:347-602-8788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2804651164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse