Healthcare Provider Details

I. General information

NPI: 1982396701
Provider Name (Legal Business Name): BARNERT AAS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROADWAY STE 204
PATERSON NJ
07514-1527
US

IV. Provider business mailing address

PO BOX 700
CLIFTON NJ
07012-0700
US

V. Phone/Fax

Practice location:
  • Phone: 973-225-0732
  • Fax:
Mailing address:
  • Phone: 201-919-8968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAM RAHAT
Title or Position: CEO
Credential:
Phone: 973-225-0732