Healthcare Provider Details

I. General information

NPI: 1639576549
Provider Name (Legal Business Name): NORMA BARROS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 70TH ST
GUTTENBERG NJ
07093-2417
US

IV. Provider business mailing address

198 GODWIN AVE
WYCKOFF NJ
07481-2018
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-0055
  • Fax:
Mailing address:
  • Phone: 973-931-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00535200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: