Provider Demographics
NPI:1215070255
Name:KABBASH, BARBARA PEARL (NP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:PEARL
Last Name:KABBASH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 KNIGHTSBRIDGE
Mailing Address - Street 2:APT F
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3610
Mailing Address - Country:US
Mailing Address - Phone:845-486-1254
Mailing Address - Fax:
Practice Address - Street 1:21 FOX ST
Practice Address - Street 2:SUITE 103
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4702
Practice Address - Country:US
Practice Address - Phone:845-431-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430324-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02883407Medicaid