Provider Demographics
NPI:1336195502
Name:AUERBACH BARBER, SMADAR H (PHD)
Entity Type:Individual
Prefix:
First Name:SMADAR
Middle Name:H
Last Name:AUERBACH BARBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SEAVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1737
Mailing Address - Country:US
Mailing Address - Phone:516-767-0671
Mailing Address - Fax:
Practice Address - Street 1:17 SEAVIEW LN
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1737
Practice Address - Country:US
Practice Address - Phone:516-767-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008093L2084P0800X
NY010164-1103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA851257Medicare ID - Type Unspecified
S19536Medicare UPIN