Healthcare Provider Details

I. General information

NPI: 1114103611
Provider Name (Legal Business Name): BARBARA ANN OPAR R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 GLEN TER
SCOTIA NY
12302-4330
US

IV. Provider business mailing address

44 GLEN TER
SCOTIA NY
12302-4330
US

V. Phone/Fax

Practice location:
  • Phone: 518-399-9728
  • Fax: 518-384-1975
Mailing address:
  • Phone: 518-399-9728
  • Fax: 518-384-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number216818-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: