Provider Demographics
NPI:1659995959
Name:LACITIGNOLA, BARBARA R (AEMT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:LACITIGNOLA
Suffix:
Gender:F
Credentials:AEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:HAINES FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12436-0413
Mailing Address - Country:US
Mailing Address - Phone:518-391-9869
Mailing Address - Fax:
Practice Address - Street 1:5742 ROUTE 23A
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12485-7715
Practice Address - Country:US
Practice Address - Phone:518-947-8024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313291146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate