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General NPI Number Information
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NPI Number | 1639320815
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Entity Type | Organization
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Legal Business Name | BARRY M. KOTEL, LCSW, PC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 125 RIVERSIDE DR SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10024-3710
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Country | US
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Telephone | 212-874-0605
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Fax | 212-874-0605
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Provider Business Mailing Address
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Address Line | 125 RIVERSIDE DR SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10024-3710
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Country | US
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Telephone | 212-874-0605
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Fax | 212-874-0605
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | MR. BARRY M. KOTEL
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Credential | LCSW
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Telephone | 212-874-0605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R013529-1
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License Number State | NY
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