Provider Demographics
NPI:1205910569
Name:PORTER, BARBARA A (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:PORTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:ADULT PRIMARY CARE CENTER, AMB CARE BLDG, 2D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ADULT PRIMARY CARE CENTER, AMB CARE BLDG, 2D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3359059OtherAETNA-US HEALTHCARE
NJP3044152OtherOXFORD HEALTH PLAN
NJ010005735 00OtherAMERICHOICE
NJ38249OtherUNIVERSITY HEALTH PLAN
PA1564458OtherAMERIHEALTH PPO PABS
NJ2400420OtherUNITED HEALTHCARE
NJ60002012OtherHORIZON-NJ HEALTH
NJ1564458OtherPENNSYLVANIA BLUE SHIELD
NJ60005007OtherHORIZON-NJ HEALTH
NJ0011401Medicaid
NJ60005009OtherHORIZON-NJ HEALTH
NJ9512616OtherCIGNA
PA1564458OtherAMERIHEALTH PPO PABS
NJ60005007OtherHORIZON-NJ HEALTH
NJG968883Medicare UPIN