Healthcare Provider Details

I. General information

NPI: 1902193576
Provider Name (Legal Business Name): DANIELLE BETH BARROCAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 09/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S SUITE 1B25
BRONX NY
10461-1138
US

IV. Provider business mailing address

1400 PELHAM PKWY S SUITE 1B25
BRONX NY
10461-1138
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5826
  • Fax:
Mailing address:
  • Phone: 718-918-5826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number265094
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: