Provider Demographics
NPI:1922129402
Name:BARCHILON, DEBORA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:
Last Name:BARCHILON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORA
Other - Middle Name:
Other - Last Name:HUBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11 GRACE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2417
Mailing Address - Country:US
Mailing Address - Phone:516-482-4064
Mailing Address - Fax:516-750-5232
Practice Address - Street 1:11 GRACE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2417
Practice Address - Country:US
Practice Address - Phone:516-482-4064
Practice Address - Fax:516-750-5232
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2214492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry