Provider Demographics
NPI:1730250127
Name:BARLEV, DAN (MD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:BARLEV
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:GPO BOX 27686
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7686
Mailing Address - Country:US
Mailing Address - Phone:888-220-1235
Mailing Address - Fax:865-450-9374
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 10 LOWER LEVEL
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-4510
Practice Address - Fax:516-663-3698
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1866752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01646244Medicaid
NYDB04064020Medicare PIN
NY4064020461Medicare PIN