Provider Demographics
NPI:1336912005
Name:NY MEMORY AND BEHAVIORAL CARE LLC
Entity Type:Organization
Organization Name:NY MEMORY AND BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-295-6335
Mailing Address - Street 1:14 RIDGEDALE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1106
Mailing Address - Country:US
Mailing Address - Phone:973-295-6335
Mailing Address - Fax:862-204-3456
Practice Address - Street 1:260 CHRISTOPHER LN STE 102A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1631
Practice Address - Country:US
Practice Address - Phone:973-295-6335
Practice Address - Fax:862-204-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty