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General NPI Number Information
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NPI Number | 1750743092
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Entity Type | Individual
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Provider Name | JESSICA BARENBOIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 350 NORTHERN BLVD STE 324-1281
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 646-450-7645
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Fax | 646-450-7645
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Provider Business Mailing Address
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Address Line | 350 NORTHERN BLVD STE 324-1281
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 646-450-7645
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Fax | 646-450-7645
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 307677
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 307677
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MD19981
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 307677
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License Number State | NY
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