Provider Demographics
NPI:1831870039
Name:PELUSO, BARBARA
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:PELUSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 FURMANVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2222
Mailing Address - Country:US
Mailing Address - Phone:347-569-7549
Mailing Address - Fax:
Practice Address - Street 1:7530 FURMANVILLE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2222
Practice Address - Country:US
Practice Address - Phone:347-569-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool