Provider Demographics
NPI:1881146546
Name:DR BRIAN D BARABAN
Entity type:Organization
Organization Name:DR BRIAN D BARABAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARABAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-698-2267
Mailing Address - Street 1:1305 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2554
Mailing Address - Country:US
Mailing Address - Phone:631-698-2267
Mailing Address - Fax:631-698-2232
Practice Address - Street 1:1305 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2554
Practice Address - Country:US
Practice Address - Phone:631-698-2267
Practice Address - Fax:631-698-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002270-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT50719Medicare UPIN