Provider Demographics
NPI:1053553115
Name:PITTMAN, BARBARA (NP/LAC INACTIVE C)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:NP/LAC INACTIVE C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7TH AVENUE AT 27TH STREET
Mailing Address - Street 2:BUILDING A 4TH FLOOR FASHION INSTITUTE OF TECHNOLOGY HE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-217-4190
Mailing Address - Fax:212-217-4191
Practice Address - Street 1:7TH AVENUE AT 27TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-217-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000885171100000X
NYF300280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No171100000XOther Service ProvidersAcupuncturist