Provider Demographics
NPI:1063581379
Name:BARABAN & BARABAN
Entity type:Organization
Organization Name:BARABAN & BARABAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-698-2267
Mailing Address - Street 1:1305 MIDDLE COUNTRY RD
Mailing Address - Street 2:STE 1
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2554
Mailing Address - Country:US
Mailing Address - Phone:631-398-2267
Mailing Address - Fax:631-698-2232
Practice Address - Street 1:1305 MIDDLE COUNTRY RD
Practice Address - Street 2:STE 1
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2554
Practice Address - Country:US
Practice Address - Phone:631-398-2267
Practice Address - Fax:631-698-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02758372Medicaid
NY5253490001Medicare NSC
NYDE2095Medicare PIN
NYPAWH91Medicare PIN