Provider Demographics
NPI:1245630714
Name:BARFIELD DOTO, JESSICA (NPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BARFIELD DOTO
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 ATWATER RD
Mailing Address - Street 2:
Mailing Address - City:GENOA
Mailing Address - State:NY
Mailing Address - Zip Code:13071-9758
Mailing Address - Country:US
Mailing Address - Phone:609-353-8920
Mailing Address - Fax:
Practice Address - Street 1:2353 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1011
Practice Address - Country:US
Practice Address - Phone:607-274-6288
Practice Address - Fax:607-274-6280
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00518600363LA2200X
NY308459363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY308459OtherNYS NP LICENSE