Provider Demographics
NPI:1609892231
Name:BARASH-WHITE, MD, PA
Entity Type:Organization
Organization Name:BARASH-WHITE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-567-7615
Mailing Address - Street 1:216 ENGLE ST. #203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-567-7615
Mailing Address - Fax:201-567-8033
Practice Address - Street 1:216 ENGLE ST. #203
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-567-7615
Practice Address - Fax:201-567-8033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARASH-WHITE, MD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-15
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA048362208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCJ7902OtherMEDICARE RAILROAD
NJ402472Medicare ID - Type Unspecified