Antwina Barber
Individual provider Active NPI Driver · Philadelphia, PA
NPI 1053911099 · NPPES record last updated Oct 29, 2020
Key facts
- NPI
- 1053911099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 2240 Ruffner St
Philadelphia, PA 19140-2820 - Phone
- (267) 444-6653
- NPI assigned
- Oct 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27199480 | PA | MD | Home Delivered Meals |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Delivered Meals | 332U00000X | 27199480 | PA | |
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
2240 Ruffner St
Philadelphia, PA 19140-2820
Mailing address
2240 Ruffner St
Philadelphia, PA 19140-2820
Phone (267) 444-6653
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.