Basic Information
| Provider Information | |||||||||
| NPI: | 1174853808 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLOMA | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 831 LITTLE BRITAIN RD | ||||||||
| Address2: | |||||||||
| City: | NEW WINDSOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125535518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454461100 | ||||||||
| FaxNumber: | 8454464581 | ||||||||
| Practice Location | |||||||||
| Address1: | 831 LITTLE BRITAIN RD | ||||||||
| Address2: | |||||||||
| City: | NEW WINDSOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125535518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454461100 | ||||||||
| FaxNumber: | 8454464581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2009 | ||||||||
| LastUpdateDate: | 07/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 013261 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | 013261 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 1085781 | 01 | NY | NCCPA CERT# | OTHER | A400124015 | 01 | NY | QSNY MCARE PTAN | OTHER | A400124065 | 01 | NY | QSNY2 MCARE PTAN | OTHER |