Provider Demographics
NPI:1548377286
Name:SCANLON, BARBARA LEE (CNM / MSN)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:SCANLON
Suffix:
Gender:F
Credentials:CNM / MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 WILLOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1832
Mailing Address - Country:US
Mailing Address - Phone:201-489-2255
Mailing Address - Fax:201-489-4799
Practice Address - Street 1:58 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1263
Practice Address - Country:US
Practice Address - Phone:201-489-2255
Practice Address - Fax:201-489-4799
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJME00018101367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife