Provider Demographics
NPI:1841565132
Name:BARINGER, BRIDGET CECILE
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:CECILE
Last Name:BARINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:C
Other - Last Name:BARINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:489 5TH AVE
Mailing Address - Street 2:FL. 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6109
Mailing Address - Country:US
Mailing Address - Phone:212-530-2288
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:489 5TH AVE
Practice Address - Street 2:FL. 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6109
Practice Address - Country:US
Practice Address - Phone:212-530-2288
Practice Address - Fax:415-520-0904
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020751363A00000X
COPA.0003618363A00000X
TXPA07787363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93223048Medicaid
CO315612YL2GMedicare PIN