Provider Demographics
NPI:1710161740
Name:HERMAN, BARBARA SUSAN (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUSAN
Last Name:HERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 PUMPKIN HOLLOW RD NO
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12529
Mailing Address - Country:US
Mailing Address - Phone:518-325-3261
Mailing Address - Fax:
Practice Address - Street 1:84 CAMPHILL ROAD
Practice Address - Street 2:
Practice Address - City:COPAKE
Practice Address - State:NY
Practice Address - Zip Code:12516
Practice Address - Country:US
Practice Address - Phone:518-329-7776
Practice Address - Fax:518-329-7773
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551934-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse