Provider Demographics
NPI:1720156094
Name:BARRY, STEVEN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:BARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N BROADWAY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1309
Mailing Address - Country:US
Mailing Address - Phone:914-376-1543
Mailing Address - Fax:914-376-2761
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:SUITE 212
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1309
Practice Address - Country:US
Practice Address - Phone:914-376-1543
Practice Address - Fax:914-376-2761
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182793207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0D1595OtherPHS
NY110219520OtherRAILROAD MEDICARE
NY01415723Medicaid
454245OtherUS HEALTHCARE
0000924OtherGHI
WS365OtherWORKMENS COMP
3401982OtherUNITED HEALTHCARE
0D1595OtherPHS
454245OtherUS HEALTHCARE