Provider Demographics
NPI:1780682419
Name:EPSTEIN, BARRY HERMAN (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:HERMAN
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENBELT RD
Mailing Address - Street 2:SUITE U16
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2354
Mailing Address - Country:US
Mailing Address - Phone:301-474-6996
Mailing Address - Fax:301-474-3501
Practice Address - Street 1:6201 GREENBELT RD
Practice Address - Street 2:SUITE U16
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:301-474-6996
Practice Address - Fax:301-474-3501
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0001700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC61600Medicare UPIN
MD410227Medicare ID - Type Unspecified