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General NPI Number Information
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NPI Number | 1760339147
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Entity Type | Individual
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Provider Name | BASSEM BARADA PHD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 628 W 151ST ST APT 5B
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City | NEW YORK
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State | NY
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Zip | 10031-2132
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Country | US
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Telephone | 516-515-0829
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Fax |
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Provider Business Mailing Address
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Address Line | 628 W 151ST ST APT 5B
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City | NEW YORK
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State | NY
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Zip | 10031-2132
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Country | US
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Telephone | 516-515-0829
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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 | 027750
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License Number State | NY
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