Provider Demographics
NPI:1851651996
Name:BENNETT, BARBARA MERYL (SPECIAL EDUCATION)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:MERYL
Last Name:BENNETT
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 PEARSALL AVENUE
Mailing Address - Street 2:LONG ISLAND CENTER FOR CHILD DEVELOPEMENT
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516
Mailing Address - Country:US
Mailing Address - Phone:516-371-1818
Mailing Address - Fax:
Practice Address - Street 1:385 PEARSALL AVENUE
Practice Address - Street 2:LONG ISLAND CENTER FOR CHILD DEVELOPEMENT
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516
Practice Address - Country:US
Practice Address - Phone:516-371-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY492129174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist