Healthcare Provider Details

I. General information

NPI: 1750207007
Provider Name (Legal Business Name): NATALIE ROSE BARRY MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 COURTLANDT AVE # 10451
BRONX NY
10451-5013
US

IV. Provider business mailing address

9109 ROOSEVELT AVE # 11372
JACKSON HEIGHTS NY
11372-7995
US

V. Phone/Fax

Practice location:
  • Phone: 718-485-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: