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General NPI Number Information
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NPI Number | 1801008560
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Entity Type | Individual
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Provider Name | THOMAS BURTON BARTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 5 FIFTH STREET
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City | BARNEGAT
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State | NJ
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Zip | 08005-1218
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Country | US
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Telephone | 609-312-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 5 FIFTH STREET
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City | BARNEGAT
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State | NJ
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Zip | 08005-1218
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Country | US
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Telephone | 609-312-7477
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 25MA07101500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 01071714A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD423776
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA07101500
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License Number State | NJ
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