Provider Demographics
NPI:1205807450
Name:HART-BARBER, PATRICE (ANP-C)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:
Last Name:HART-BARBER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5574 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5452
Mailing Address - Country:US
Mailing Address - Phone:716-634-2671
Mailing Address - Fax:716-634-2673
Practice Address - Street 1:5574 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5452
Practice Address - Country:US
Practice Address - Phone:716-634-2671
Practice Address - Fax:716-634-2673
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304115363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA9173Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NYQ60804Medicare UPIN