Provider Demographics
NPI:1649539628
Name:BARROLLE, ELI
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:BARROLLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 DELL CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-6003
Mailing Address - Country:US
Mailing Address - Phone:267-693-8519
Mailing Address - Fax:
Practice Address - Street 1:725 DELL CT
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-6003
Practice Address - Country:US
Practice Address - Phone:267-693-8519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker