Provider Demographics
NPI:1952680985
Name:PORRECA, BARBARA SUSAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:SUSAN
Last Name:PORRECA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1789 MERIKOKE AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3311
Mailing Address - Country:US
Mailing Address - Phone:516-781-2560
Mailing Address - Fax:516-781-2560
Practice Address - Street 1:300 COMMUNITY DR
Practice Address - Street 2:PRE ADMISSION TESTING
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3816
Practice Address - Country:US
Practice Address - Phone:516-562-3722
Practice Address - Fax:516-562-2159
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF305823-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health