Healthcare Provider Details

I. General information

NPI: 1861434821
Provider Name (Legal Business Name): BARRY G. PEARLSTEIN RD, CDN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 ALBANY POST RD
MONTROSE NY
10548-1454
US

IV. Provider business mailing address

2 LINDEN LN
NANUET NY
10954-3814
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-4400
  • Fax: 914-788-4252
Mailing address:
  • Phone: 845-425-0188
  • Fax: 845-425-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: