Provider Demographics
NPI:1710570239
Name:BARCO HEALTH PC
Entity Type:Organization
Organization Name:BARCO HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHMITHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JEERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-275-5060
Mailing Address - Street 1:1517 PEACOCK CT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-5608
Mailing Address - Country:US
Mailing Address - Phone:201-275-5060
Mailing Address - Fax:
Practice Address - Street 1:1401 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3731
Practice Address - Country:US
Practice Address - Phone:201-275-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1891904272OtherNPI NUMBER