Provider Demographics
NPI:1851713382
Name:BARKEY, RYAN (RDA-A, FASMLAP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BARKEY
Suffix:
Gender:M
Credentials:RDA-A, FASMLAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-4902
Mailing Address - Country:US
Mailing Address - Phone:631-987-9643
Mailing Address - Fax:
Practice Address - Street 1:15 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754
Practice Address - Country:US
Practice Address - Phone:631-987-9643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409640146N00000X, 390200000X
NY4586440235500000X
NY12041708246Z00000X, 247200000X, 235500000X
NY37825865367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program