Provider Demographics
NPI:1376677880
Name:KIDNEY, BARBARA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:KIDNEY
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 1:275 RT 17K
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-567-0857
Mailing Address - Fax:845-567-0857
Practice Address - Street 1:275 RT 17K
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-567-0857
Practice Address - Fax:845-567-0857
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011683103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV80411Medicare UPIN