Provider Demographics
NPI:1629071998
Name:BARBIS, JOHN M (MA, PT, OCS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:BARBIS
Suffix:
Gender:M
Credentials:MA, PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:420 BAINBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1568
Mailing Address - Country:US
Mailing Address - Phone:215-629-3837
Mailing Address - Fax:215-629-5531
Practice Address - Street 1:261 OLD YORK ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3709
Practice Address - Country:US
Practice Address - Phone:215-886-5520
Practice Address - Fax:215-558-6103
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-00018442251X0800X
PAPT-000807E2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA185874SAVMedicare PIN