Provider Demographics
NPI:1891212650
Name:BARCIA, ROSE MARIA
Entity Type:Individual
Prefix:
First Name:ROSE MARIA
Middle Name:
Last Name:BARCIA
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 1:1421 85TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3405
Mailing Address - Country:US
Mailing Address - Phone:1718-541-6037
Mailing Address - Fax:
Practice Address - Street 1:1421 85TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3405
Practice Address - Country:US
Practice Address - Phone:718-541-6037
Practice Address - Fax:718-541-6037
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$Medicaid