Healthcare Provider Details

I. General information

NPI: 1659263457
Provider Name (Legal Business Name): MD MEMORY AND BEHAVIORAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 GUILFORD AVE # 1526
BALTIMORE MD
21202-3707
US

IV. Provider business mailing address

575 ROUTE 28 STE 2108
RARITAN NJ
08869-1354
US

V. Phone/Fax

Practice location:
  • Phone: 973-295-6335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW BARNAS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-519-7447