Healthcare Provider Details
I. General information
NPI: 1528351152
Provider Name (Legal Business Name): PATRICIA BARRON APN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2011
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
256 COLUMBIA TPKE STE 102
FLORHAM PARK NJ
07932-1209
US
IV. Provider business mailing address
256 COLUMBIA TPKE STE 102
FLORHAM PARK NJ
07932-1209
US
V. Phone/Fax
- Phone: 973-460-4566
- Fax: 718-761-3162
- Phone: 973-460-4566
- Fax: 718-761-3162
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0808X |
| Taxonomy | Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 26NO07313300 |
| License Number State | NJ |
VIII. Authorized Official
Name: MS.
PATRICIA
BARRON
Title or Position: OWNER
Credential: APN
Phone: 973-460-4566