Provider Demographics
NPI:1356340145
Name:BARNES, EDWARD S (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:S
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:212-209-3234
Practice Address - Street 1:317 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-726-7434
Practice Address - Fax:212-209-3234
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY165913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05372523Medicaid
NY87F541Medicare ID - Type Unspecified