Provider Demographics
NPI:1588703540
Name:NUSSBAUM, BARBARA BARLETTA (RPH)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:BARLETTA
Last Name:NUSSBAUM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4661 24TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3556
Mailing Address - Country:US
Mailing Address - Phone:703-528-7193
Mailing Address - Fax:703-313-9666
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 309
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-313-8400
Practice Address - Fax:703-313-9666
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist