Provider Demographics
NPI:1659177574
Name:BARBACCIA, KATHERINE (ND)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BARBACCIA
Suffix:
Gender:
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CANAL VIEW BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2833
Mailing Address - Country:US
Mailing Address - Phone:585-469-0970
Mailing Address - Fax:
Practice Address - Street 1:500 CANAL VIEW BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2833
Practice Address - Country:US
Practice Address - Phone:585-469-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000749175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath