Provider Demographics
NPI:1861669699
Name:SAAVEDRA, BARBARA MARIA (LPN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:MARIA
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:MARIA
Other - Last Name:SAAVEDRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:296 HUGUENOT ST
Mailing Address - Street 2:APT.H
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7223
Mailing Address - Country:US
Mailing Address - Phone:914-637-2699
Mailing Address - Fax:
Practice Address - Street 1:296 HUGUENOT ST
Practice Address - Street 2:APT.H
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7223
Practice Address - Country:US
Practice Address - Phone:914-637-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139211-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02389288Medicaid