Provider Demographics
NPI:1245708676
Name:HAMA, BARBARA WADZANAYI (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:WADZANAYI
Last Name:HAMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635
Mailing Address - Street 2:
Mailing Address - City:MOUNT FREEDOM
Mailing Address - State:NJ
Mailing Address - Zip Code:07970-0635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:631 S QUAKER LN
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1043
Practice Address - Country:US
Practice Address - Phone:860-233-5133
Practice Address - Fax:860-233-5212
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-03
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9748363L00000X, 363LA2200X
NJ26NR14658200163WH0500X
NJ26NJ00875500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health