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General NPI Number Information
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NPI Number | 1588821474
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Entity Type | Individual
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Provider Name | JORDAN DANIEL BARBER DAOM, L.AC, L.M.T.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 06/28/2025
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Provider Practice Location Address
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Address Line | 118 W 72ND ST REAR LOBBY
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City | NEW YORK
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State | NY
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Zip | 10023-3316
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Country | US
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Telephone | 917-409-6659
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Fax |
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Provider Business Mailing Address
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Address Line | 140 N BELLE MEAD AVE STE A
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City | EAST SETAUKET
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State | NY
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Zip | 11733-6400
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Country | US
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Telephone | 316-898-6626
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 018268
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 3667
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License Number State | NY
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