Provider Demographics
NPI:1194153262
Name:BARCAVAGE, SHAUN RICHARD (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:SHAUN
Middle Name:RICHARD
Last Name:BARCAVAGE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 MINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:RIEGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18077-9543
Mailing Address - Country:US
Mailing Address - Phone:917-657-6671
Mailing Address - Fax:
Practice Address - Street 1:1565 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-4744
Practice Address - Country:US
Practice Address - Phone:610-867-5365
Practice Address - Fax:610-867-5366
Is Sole Proprietor?:No
Enumeration Date:2013-10-28
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00461900363LF0000X
NY338381363LF0000X
PASP028181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily