Provider Demographics
NPI:1508869363
Name:FIELDS, BARRY ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
Last Name:FIELDS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-3026
Mailing Address - Country:US
Mailing Address - Phone:914-271-5819
Mailing Address - Fax:914-271-5717
Practice Address - Street 1:409 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-3026
Practice Address - Country:US
Practice Address - Phone:914-271-5819
Practice Address - Fax:914-271-5717
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003182213E00000X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00606726Medicaid
NY00606726Medicaid
NYP34321Medicare ID - Type Unspecified