Provider Demographics
NPI:1376884643
Name:NOSKOW, BARRY
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:NOSKOW
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 1:1303 53RD ST
Mailing Address - Street 2:PMB # 139
Mailing Address - City:BROOKLYN
Mailing Address - State:PA
Mailing Address - Zip Code:11219
Mailing Address - Country:US
Mailing Address - Phone:718-438-8400
Mailing Address - Fax:
Practice Address - Street 1:5824 14TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-438-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0289711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice