Healthcare Provider Details

I. General information

NPI: 1710802335
Provider Name (Legal Business Name): BARRY BACHENHEIMER NREMT, ED.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 METRO BLVD STE 4222
NUTLEY NJ
07110-6101
US

IV. Provider business mailing address

123 METRO BLVD STE 4222
NUTLEY NJ
07110-6101
US

V. Phone/Fax

Practice location:
  • Phone: 866-660-5142
  • Fax:
Mailing address:
  • Phone: 866-660-5142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number552588
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: