| Barry Reisberg, Md, Pc | |
|
20 Waterside Plaza 7k New York NY 10010-2619 | |
| (212) 889-7579 | |
| (212) 263-6991 |
| Full Name | Barry Reisberg, Md, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20 Waterside Plaza, New York, New York |
| Authorized Official Name and Position | Barry Reisberg (PRESIDENT) |
| Authorized Official Contact | 2128897579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barry Reisberg, Md, Pc 20 Waterside Plaza 7k New York NY 10010-2619 Ph: (212) 889-7579 | Barry Reisberg, Md, Pc 20 Waterside Plaza 7k New York NY 10010-2619 Ph: (212) 889-7579 |
| NPI Number | 1013385376 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 09/03/2015 |
| Medicare PECOS PAC ID | 8224333984 |
|---|---|
| Medicare Enrollment ID | O20160218000895 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013385376 | NPI | - | NPPES |
| MD00563713 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Barry Reisberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023155504 PECOS PAC ID: 6709066590 Enrollment ID: I20110211000011 |
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