Provider Demographics
NPI:1609836550
Name:MACEY, BARBARA A (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:MACEY
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 1:125 LATTIMORE RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4159
Mailing Address - Country:US
Mailing Address - Phone:575-442-2075
Mailing Address - Fax:585-244-4298
Practice Address - Street 1:1736 RIDGE RD E
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14622-2157
Practice Address - Country:US
Practice Address - Phone:585-266-8401
Practice Address - Fax:585-266-2029
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300986363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019300986OtherBLUES
NYNP0500OtherPREFERRED CARE
NYNP0500OtherPREFERRED CARE
NYP14690Medicare UPIN