Provider Demographics
NPI:1174291306
Name:BARNETT, TYRONE
Entity Type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SOUTH ST STE 3S8
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1752
Mailing Address - Country:US
Mailing Address - Phone:845-205-2756
Mailing Address - Fax:
Practice Address - Street 1:515 MADISON AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5460
Practice Address - Country:US
Practice Address - Phone:845-205-2756
Practice Address - Fax:845-367-5503
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor