Provider Demographics
NPI:1881463461
Name:ABA-BARUCH, BRACHA (RN)
Entity type:Individual
Prefix:MS
First Name:BRACHA
Middle Name:
Last Name:ABA-BARUCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 39TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4461
Mailing Address - Country:US
Mailing Address - Phone:347-493-7733
Mailing Address - Fax:
Practice Address - Street 1:1546 39TH ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4461
Practice Address - Country:US
Practice Address - Phone:347-493-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY916788163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse