MEDICARE: ELEANOR BARBERA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	10963	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02856	OTHER	NY	GHI MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023032117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEANOR BARBERA PH.D.

Provider Business Mailing Address
First Line	:	3420 79TH ST
Second Line	:	#3A
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2607
Country	:	US
Telephone Number	:	646-322-2885
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 79TH ST
Second Line	:	APT 3A
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2601
Country	:	US
Telephone Number	:	212-851-8100
Fax Number	:	889-772-5478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/18/2022

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Directions to “ ELEANOR BARBERA PH.D.” Practice Location

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