Basic Information
| Provider Information | |||||||||
| NPI: | 1891753844 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNOSKI | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | F. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1022 N UNION ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170572158 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1022 N UNION ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170572158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179440491 | ||||||||
| FaxNumber: | 7179441436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2006 | ||||||||
| LastUpdateDate: | 02/01/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD015436E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P150036 | 01 | PA | GATEWAY | OTHER | 0006398030001 | 05 | PA | MEDICAID | 000150036 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 102767 | 01 | PA | UNISON | OTHER | 478615 | 01 | PA | AETNA | OTHER |