Provider Demographics
NPI:1770578387
Name:BARBACCI, DARREN BASIL (DPM)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:BASIL
Last Name:BARBACCI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 HARRISBURG PIKE STE 329
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:866-871-0851
Mailing Address - Fax:610-857-6202
Practice Address - Street 1:2108 HARRISBURG PIKE STE 329
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:866-871-0851
Practice Address - Fax:610-857-6202
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003817L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001496296000008Medicaid
PA747510Medicare PIN
PAU34811Medicare UPIN
PA001496296000008Medicaid