Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 421400 | NY |
N | 363LW0102X | Nurse Practitioner - Women's Health | 421400 | NY |
NPI | 1073820924 |
---|---|
Provider Name | Marichu Bascar Barria |
First Address | Elmhurst, NY 11373-2744 |
Second Address | New York, NY 10065-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2010 |
Last Update Date | 14/03/2021 |