Provider Demographics
NPI:1952782997
Name:GEORGE, BARBARA JEAN (AGNP)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-1920
Mailing Address - Country:US
Mailing Address - Phone:631-885-3564
Mailing Address - Fax:
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4064
Practice Address - Country:US
Practice Address - Phone:516-663-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF307206363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health