Provider Demographics
NPI:1821046731
Name:NEPHEW, BARBARA G (RD/CDN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:G
Last Name:NEPHEW
Suffix:
Gender:F
Credentials:RD/CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CATTARAUGUS INDIAN RESERVATION HEALTH CENTER
Mailing Address - Street 2:36 THOMAS INDIAN SCHOOL DR
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081
Mailing Address - Country:US
Mailing Address - Phone:716-532-5582
Mailing Address - Fax:716-532-1428
Practice Address - Street 1:CATTARAUGUS INDIAN RESERVATION HEALTH CENTER
Practice Address - Street 2:36 THOMAS INDIAN SCHOOL DR
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081
Practice Address - Country:US
Practice Address - Phone:716-532-5582
Practice Address - Fax:716-532-1428
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003579133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6512619OtherINDEPENDENT HEALTH
NYDD2457Medicare PIN