1588918668 NPI number — MRS. MICHELLE BARNES CERTIFIED OCCUPATION

Table of content: MRS. MICHELLE BARNES CERTIFIED OCCUPATION (NPI 1588918668)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588918668 NPI number — MRS. MICHELLE BARNES CERTIFIED OCCUPATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNES
Provider First Name:
MICHELLE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CERTIFIED OCCUPATION
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHMID
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CERTIFIED OCCUPATION
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588918668
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7540 N BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED HOOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-464-7390
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 ALDEN PLACE
Provider Second Line Business Practice Location Address:
MILLBROOK CENTRAL SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
MILLBROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-677-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X , with the licence number:  008186-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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