Healthcare Provider Details

I. General information

NPI: 1669541884
Provider Name (Legal Business Name): BARRY SNOW PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 17TH ST ROOM # 1029
NEW YORK NY
10003-3804
US

IV. Provider business mailing address

301 E 17TH ST ROOM # 1029
NEW YORK NY
10003-3804
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-6606
  • Fax: 212-598-6468
Mailing address:
  • Phone: 212-598-6606
  • Fax: 212-598-6468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number007855
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: