Provider Demographics
NPI:1184272619
Name:BARKLEY, INDIA SHENIFE (LAC)
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:SHENIFE
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 194TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3099
Mailing Address - Country:US
Mailing Address - Phone:917-916-2491
Mailing Address - Fax:
Practice Address - Street 1:109 W 38TH ST RM 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3642
Practice Address - Country:US
Practice Address - Phone:917-916-2491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005277-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist