Healthcare Provider Details

I. General information

NPI: 1265639926
Provider Name (Legal Business Name): BARRY MARK USLIANER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MARSHALL RD C/O NORTHERN PSYCHIATRIC SERVICES
WAPPINGERS FALLS NY
12590-4132
US

IV. Provider business mailing address

9 SANDLEWOOD LN
RIDGEFIELD CT
06877-3346
US

V. Phone/Fax

Practice location:
  • Phone: 914-715-7032
  • Fax: 203-244-5394
Mailing address:
  • Phone: 914-715-7032
  • Fax: 203-244-5394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number010998
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number010998
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number010998
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number010998
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: