Provider Demographics
NPI:1184716375
Name:BARBANEL, LAURA (EDD, ABPP)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BARBANEL
Suffix:
Gender:F
Credentials:EDD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PIERREPONT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2452
Mailing Address - Country:US
Mailing Address - Phone:718-624-6507
Mailing Address - Fax:718-852-7124
Practice Address - Street 1:62 PIERREPONT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2452
Practice Address - Country:US
Practice Address - Phone:718-624-6507
Practice Address - Fax:718-852-7124
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003623-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY003623-1OtherNY LICENSE