Provider Demographics
NPI:1972788875
Name:BARBER, NATHAN DANIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:DANIEL
Last Name:BARBER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4203
Mailing Address - Country:US
Mailing Address - Phone:718-292-7060
Mailing Address - Fax:718-292-1317
Practice Address - Street 1:3225 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4203
Practice Address - Country:US
Practice Address - Phone:718-292-7060
Practice Address - Fax:718-292-1317
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01893883Medicaid