Provider Demographics
NPI:1588821474
Name:BARBER, JORDAN DANIEL (DAOM, LAC, LMT)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:DANIEL
Last Name:BARBER
Suffix:
Gender:M
Credentials:DAOM, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N BELLE MEAD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6400
Mailing Address - Country:US
Mailing Address - Phone:316-898-6626
Mailing Address - Fax:
Practice Address - Street 1:118 W 72ND ST REAR LOBBY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3316
Practice Address - Country:US
Practice Address - Phone:917-409-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018268225700000X
NY3667171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist