Provider Demographics
NPI:1497879563
Name:STERN, BARRY L (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:STERN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E 40TH ST
Mailing Address - Street 2:PENTHOUSE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0501
Mailing Address - Country:US
Mailing Address - Phone:212-684-5377
Mailing Address - Fax:
Practice Address - Street 1:21 E 40TH ST
Practice Address - Street 2:PENTHOUSE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0501
Practice Address - Country:US
Practice Address - Phone:212-684-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014432103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6407242Medicare ID - Type Unspecified