Jordan David Barnard

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Woodbury, CT

NPI 1205116191 · NPPES record last updated Aug 23, 2011

Key facts

NPI
1205116191
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
126 Sherman Hill Rd Apt A12
Woodbury, CT 06798-3664
Phone
(203) 263-2162
NPI assigned
Aug 23, 2011
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

126 Sherman Hill Rd Apt A12
Woodbury, CT 06798-3664

Mailing address

126 Sherman Hill Rd Apt A12
Woodbury, CT 06798-3664
Phone (203) 263-2162

Other providers in Woodbury, CT

All providers in Woodbury, CT · Student in an Organized Health Care Education/Training Program in Connecticut

Sources for this page

Verify at the official NPI Registry.