Healthcare Provider Details

I. General information

NPI: 1336195502
Provider Name (Legal Business Name): SMADAR H AUERBACH BARBER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 SEAVIEW LN
PORT WASHINGTON NY
11050-1737
US

IV. Provider business mailing address

17 SEAVIEW LN
PORT WASHINGTON NY
11050-1737
US

V. Phone/Fax

Practice location:
  • Phone: 516-767-0671
  • Fax:
Mailing address:
  • Phone: 516-767-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number010164-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberPS008093L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: