Provider Demographics
NPI:1851603054
Name:GAFFNEY, BARRY (LPN)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:GAFFNEY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1391
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-1391
Mailing Address - Country:US
Mailing Address - Phone:518-451-9403
Mailing Address - Fax:
Practice Address - Street 1:71 BRADFORD ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2608
Practice Address - Country:US
Practice Address - Phone:518-451-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301024164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse