Provider Demographics
NPI:1679543532
Name:BARTON, GERALDINE MEROLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:MEROLA
Last Name:BARTON
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 1:159 GREEN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3736
Mailing Address - Country:US
Mailing Address - Phone:845-338-3250
Mailing Address - Fax:845-339-2382
Practice Address - Street 1:159 GREEN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3736
Practice Address - Country:US
Practice Address - Phone:845-338-3250
Practice Address - Fax:845-339-2382
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009785-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV51761Medicare ID - Type UnspecifiedPSYCHOLOGIST