Provider Demographics
NPI:1689790685
Name:BARCLAY, THERESA LAMB (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:LAMB
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:M. THERESA
Other - Middle Name:LAMB
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4 STUYVESANT OVAL APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 EAST 77TH STREET
Practice Address - Street 2:LENOX HILL HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-434-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002014-1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical