Provider Demographics
NPI:1962492389
Name:CARTABUKE-MULE, BARBARA (PA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CARTABUKE-MULE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 9 PRIMARY MEDICAL CARE OF SUFFOLK COUNTY PC
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2830
Mailing Address - Country:US
Mailing Address - Phone:631-361-3363
Mailing Address - Fax:631-361-3579
Practice Address - Street 1:329 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 9 PRIMARY MEDICAL CARE OF SUFFOLK COUNTY PC
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2830
Practice Address - Country:US
Practice Address - Phone:631-361-3363
Practice Address - Fax:631-361-3579
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003049363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0F3161Medicare ID - Type Unspecified
S78562Medicare UPIN