MEDICARE: DR. SETH BARNETSKY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP444936	PA
2	183500000X	Pharmacist	RPI006592	PA

General Provider Information

NPI Number	:	1588117477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SETH BARNETSKY

Provider Business Mailing Address
First Line	:	101 S TULPEHOCKEN ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1011
Country	:	US
Telephone Number	:	570-345-4966
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S TULPEHOCKEN ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1011
Country	:	US
Telephone Number	:	570-345-4966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2016
Last Update Date	:	07/27/2016

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