Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X007509-1 | NY |
NPI | 1003884115 |
---|---|
Provider Name | Dr. Jennifer Heberle Barnes |
First Address | Canandaigua, NY 14424-2101 |
Second Address | Canandaigua, NY 14424-2101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 23/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
109889AN | PREFERRED CARE (01) | NY |
5537039 | AETNA (01) | NY |
P010007509 | EXCELLUS (01) | NY |