Provider Demographics
NPI:1306931696
Name:BARBER, TIMOTHY P (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:P
Last Name:BARBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10814 72ND AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5350
Mailing Address - Country:US
Mailing Address - Phone:718-520-8480
Mailing Address - Fax:718-261-7886
Practice Address - Street 1:10814 72ND AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5350
Practice Address - Country:US
Practice Address - Phone:718-520-8480
Practice Address - Fax:718-261-7886
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008553-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX98191OtherBLUE CROSS / BLUE SHIELD
NYP1091453OtherOXFORD HEALTH PLANS
NY02453AMedicare ID - Type UnspecifiedMEDICARE
NYU65911Medicare UPIN