Healthcare Provider Details

I. General information

NPI: 1477571875
Provider Name (Legal Business Name): BARBARA ANN BUXTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6729 MYRTLE AVE
GLENDALE NY
11385-7063
US

IV. Provider business mailing address

1543 200TH ST
BAYSIDE NY
11360-1032
US

V. Phone/Fax

Practice location:
  • Phone: 718-456-7001
  • Fax: 718-456-9470
Mailing address:
  • Phone: 718-352-7046
  • Fax: 718-456-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO-38335-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: