Provider Demographics
NPI:1710986534
Name:BARBERO, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BARBERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 PEACH ST STE 106B
Mailing Address - Street 2:SUITE 106B
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3330 PEACH ST STE 106B
Practice Address - Street 2:SUITE 106B
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2771
Practice Address - Country:US
Practice Address - Phone:814-877-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065350L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016970510006Medicaid
PA974958OtherBLUE SHIELD
PA158177OtherUNISON
PA080175926OtherRR MEDICARE
PA1541193OtherGATEWAY
NY01831790OtherNY MEDICAL ASSISTANCE
OH0235892OtherOH MEDICAL ASSISTANCE
WV1068740OtherW. VIRGINIA WORKERS COMP
NY00025400301OtherUNIVERA
PA1048634OtherAETNA
PA212490OtherUPMC
PA1541193OtherGATEWAY
G17170Medicare UPIN