Provider Demographics
NPI:1013607845
Name:BARNES, CHINA KENYATTA LE'SEUR
Entity Type:Individual
Prefix:
First Name:CHINA
Middle Name:KENYATTA LE'SEUR
Last Name:BARNES
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 1:319 MARTHA AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2903
Mailing Address - Country:US
Mailing Address - Phone:716-866-6424
Mailing Address - Fax:
Practice Address - Street 1:2474 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3842
Practice Address - Country:US
Practice Address - Phone:716-866-6424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician