Provider Demographics
NPI:1871747758
Name:BARBA, ANITA VALENTINA (FNP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:VALENTINA
Last Name:BARBA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2302
Mailing Address - Country:US
Mailing Address - Phone:212-988-8900
Mailing Address - Fax:212-772-1308
Practice Address - Street 1:742 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4251
Practice Address - Country:US
Practice Address - Phone:212-988-8900
Practice Address - Fax:212-772-1308
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily