Provider Demographics
NPI:1023862638
Name:BARRY, MICHELLE (RDN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CATAWBA CT
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2303
Mailing Address - Country:US
Mailing Address - Phone:845-521-9996
Mailing Address - Fax:
Practice Address - Street 1:3 CATAWBA CT
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2303
Practice Address - Country:US
Practice Address - Phone:845-521-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered