Provider Demographics
NPI:1215993605
Name:BARBER, JONATHAN ALEXANDER SR (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ALEXANDER
Last Name:BARBER
Suffix:SR
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 1:4 MIX PL
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1911
Mailing Address - Country:US
Mailing Address - Phone:585-230-4579
Mailing Address - Fax:
Practice Address - Street 1:41 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:NY
Practice Address - Zip Code:14125-1014
Practice Address - Country:US
Practice Address - Phone:585-948-8077
Practice Address - Fax:585-948-9159
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3343401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9512796OtherINDEPENDENT HEALTH
NYP019334340OtherBLUE CHOICE
NY00027001201OtherUNIVERA
NY000560919001OtherBCBS WNY
NY156044BFOtherPREFERRED CARE
NY02624073Medicaid