Provider Demographics
NPI:1679837223
Name:TOLBERT, BARBARA E (BARBARA TOLBERT MED)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:BARBARA TOLBERT MED
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:EIDUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BARBARA TOLBERT
Mailing Address - Street 1:5746 EAST LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9458
Mailing Address - Country:US
Mailing Address - Phone:716-627-9020
Mailing Address - Fax:
Practice Address - Street 1:5746 EAST LN
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:NY
Practice Address - Zip Code:14085-9458
Practice Address - Country:US
Practice Address - Phone:716-627-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist