MEDICARE: BARRY PINTO

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	163W00000X	Registered Nurse	679962-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	679962-1	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1780065086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY PINTO

Provider Business Mailing Address
First Line	:	62 E WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3516
Country	:	US
Telephone Number	:	516-250-5627
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 E WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3516
Country	:	US
Telephone Number	:	516-250-5627
Fax Number	:

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

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	06/11/2015

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Directions to “ BARRY PINTO ” Practice Location

Language	Start Address	Practice Location

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