Provider Demographics
NPI:1891819280
Name:BARBERA, JEANNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:BARBERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WEST EDMONSTON DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1246
Mailing Address - Country:US
Mailing Address - Phone:301-251-3704
Mailing Address - Fax:301-251-1783
Practice Address - Street 1:50 WEST EDMONSTON DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1246
Practice Address - Country:US
Practice Address - Phone:301-251-3704
Practice Address - Fax:301-251-1783
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0031019207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD258951600Medicaid
MD258951600Medicaid
54475Medicare ID - Type Unspecified