Provider Demographics
NPI:1801553490
Name:D'AMATO, BARBARA
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:D'AMATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:STUCKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6735 RIDGE BOULEVARD
Mailing Address - Street 2:#6G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5234
Mailing Address - Country:US
Mailing Address - Phone:718-491-4104
Mailing Address - Fax:
Practice Address - Street 1:6735 RIDGE BOULEVARD
Practice Address - Street 2:#6G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5234
Practice Address - Country:US
Practice Address - Phone:718-491-4104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000004102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst