Type not stated

BARAQUE IVAN DARIO MD

Debarred entity

United States. Named in 2 sanctions listings.

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Sanctions and listings2

  • Effective
    3 Nov 2014

    Official designation

    New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States

    omig.ny.gov

  • Effective
    20 Feb 2015

    Official designation

    New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States

    DISQUALIFICATION

    nj.gov

Identifiers2

IdentifierNumber
ID number00161270
NPI number1811059967

Other names1

Also known as1

BARAQUE, IVAN DARIO

Addresses1

  • 4 WOODCREST COURT, WEST NYACK, NY 10994

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