Provider Demographics
NPI:1831224385
Name:DEACON, BARBARA A (NP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:DEACON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4536
Mailing Address - Country:US
Mailing Address - Phone:732-393-1616
Mailing Address - Fax:732-376-6017
Practice Address - Street 1:318 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3910
Practice Address - Country:US
Practice Address - Phone:732-376-6012
Practice Address - Fax:732-376-6017
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00124600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily