Provider Demographics
NPI:1174661797
Name:TRILLING, BARBARA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:TRILLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 BARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2105
Mailing Address - Country:US
Mailing Address - Phone:718-447-7079
Mailing Address - Fax:718-720-6944
Practice Address - Street 1:482 BARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2105
Practice Address - Country:US
Practice Address - Phone:718-447-7079
Practice Address - Fax:718-720-6944
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005169103TC0700X, 103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY147513OtherVALUE OPTIONS PIN#
NY0090816OtherGHI PIN#
NY147513OtherVALUE OPTIONS PIN#