Provider Demographics
NPI:1205912854
Name:BARASH, FRED S (MD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:S
Last Name:BARASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:S
Other - Last Name:BARASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JD
Mailing Address - Street 1:333 E SHORE RD
Mailing Address - Street 2:201
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2900
Mailing Address - Country:US
Mailing Address - Phone:516-829-3044
Mailing Address - Fax:516-829-3045
Practice Address - Street 1:333 E SHORE RD
Practice Address - Street 2:201
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2900
Practice Address - Country:US
Practice Address - Phone:516-829-3044
Practice Address - Fax:516-829-3045
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134482208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB87387Medicare UPIN