Individual
SHANTA F BARTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 CLAIRMOUNT ST, ROCHESTER, NY 14621-4204
(585) 284-1716
Mailing address
PO BOX 13644, ROCHESTER, NY 14613-0644
(585) 284-1716
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
384267858
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-4819001
—
NY
Enumeration date
04/27/2018
Last updated
04/27/2018
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