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General NPI Number Information
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NPI Number | 1093755928
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Entity Type | Individual
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Provider Name | BARRY B PLATT PHD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 11/20/2010
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Provider Practice Location Address
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Address Line | 1 LAKEVIEW PARK
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City | ROCHESTER
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State | NY
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Zip | 14613-1708
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Country | US
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Telephone | 585-647-6414
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Fax | 585-458-3477
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Provider Business Mailing Address
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Address Line | 58 SUMMIT DR
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City | ROCHESTER
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State | NY
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Zip | 14620-3130
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Country | US
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Telephone | 585-461-2017
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0063971
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License Number State | NY
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