Provider Demographics
NPI:1316257082
Name:BARTH, GAIL ANNETTE (COTA)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:ANNETTE
Last Name:BARTH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 W COMMERCIAL ST
Mailing Address - Street 2:SUITE 2795
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-2407
Mailing Address - Country:US
Mailing Address - Phone:585-487-3555
Mailing Address - Fax:
Practice Address - Street 1:349 W COMMERCIAL ST
Practice Address - Street 2:SUITE 2795
Practice Address - City:EAST ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14445-2407
Practice Address - Country:US
Practice Address - Phone:585-487-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001493-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist