Provider Demographics
NPI:1932183928
Name:LOUGHLIN, BARBARA J (CNM)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:LOUGHLIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9660 LOUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:SAUQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:13456-2706
Mailing Address - Country:US
Mailing Address - Phone:315-737-5193
Mailing Address - Fax:
Practice Address - Street 1:10 EATON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1124
Practice Address - Country:US
Practice Address - Phone:315-824-2651
Practice Address - Fax:315-824-4011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360176363LX0001X
NYF000132367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY318143OtherMVP
NY0299702OtherGHI
NY01300669Medicaid