Healthcare Provider Details

I. General information

NPI: 1871644666
Provider Name (Legal Business Name): DEAN MICHAEL BARTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VALLEY RD SUITE 102
MOUNT ARLINGTON NJ
07856-2316
US

IV. Provider business mailing address

400 VALLEY RD SUITE 102
MOUNT ARLINGTON NJ
07856-2316
US

V. Phone/Fax

Practice location:
  • Phone: 973-770-7899
  • Fax: 973-770-7840
Mailing address:
  • Phone: 973-770-7899
  • Fax: 973-770-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA05155300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: