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General NPI Number Information
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NPI Number | 1205822459
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Entity Type | Individual
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Provider Name | BARBARA J REALE CNM
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Gender | Female
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 3400 SPRUCE STREET 100 CENTREX
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 215-662-2730
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Fax | 908-788-6483
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Provider Business Mailing Address
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Address Line | 3400 SPRUCE STREET 100 CENTREX
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 215-662-2730
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Fax | 908-788-6483
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25ME00015301
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010024
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00015301
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License Number State | NJ
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