Provider Demographics
NPI:1427072446
Name:BARBA, JOSE PARAS (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:PARAS
Last Name:BARBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-0224
Mailing Address - Country:US
Mailing Address - Phone:607-324-2340
Mailing Address - Fax:607-324-1697
Practice Address - Street 1:4605 MACCORKLE AVE SW
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1311
Practice Address - Country:US
Practice Address - Phone:304-766-3668
Practice Address - Fax:304-766-5654
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1398322085R0001X
WV271802085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00697452Medicaid
NY00697452Medicaid
NY00697452Medicaid