Provider Demographics
NPI:1679881619
Name:BARHOLD, LOREN (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:LOREN
Middle Name:
Last Name:BARHOLD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LEWIS CIR
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4014
Mailing Address - Country:US
Mailing Address - Phone:631-926-7801
Mailing Address - Fax:
Practice Address - Street 1:1000 TENTH AVE
Practice Address - Street 2:ROOSEVELT HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-523-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical