Provider Demographics
NPI:1821422288
Name:MEZRAHI, BARBARA MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MICHELLE
Last Name:MEZRAHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 DUBOIS AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3335
Mailing Address - Country:US
Mailing Address - Phone:516-859-7125
Mailing Address - Fax:
Practice Address - Street 1:128 DUBOIS AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3335
Practice Address - Country:US
Practice Address - Phone:516-859-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720183131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist