Provider Demographics
NPI:1366195687
Name:BARBOUR, ALAA (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALAA
Middle Name:
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1680 NJ ROUTE 23
Mailing Address - Street 2:STE 180
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:800-633-8446
Mailing Address - Fax:
Practice Address - Street 1:1680 NJ ROUTE 23
Practice Address - Street 2:STE 180
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:800-633-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical