Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | C10000823 | DE |
NPI | 1003873415 |
---|---|
Provider Name | Dr. Jose L Barriocanal |
First Address | Seaford, DE 19973-3820 |
Second Address | Seaford, DE 19973-3820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 11/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C48648 | (02) | DE |