MEDICARE: VICKI BARNETT PSY D PC

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	102L00000X	Psychoanalyst	35S100321100	NJ

General Provider Information

NPI Number	:	1447463971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICKI BARNETT PSY D PC

Provider Business Mailing Address
First Line	:	288 JONES RD
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-4411
Country	:	US
Telephone Number	:	917-853-7064
Fax Number	:	718-302-3835

Provider Business Practice Location Address
First Line	:	288 JONES RD
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-4411
Country	:	US
Telephone Number	:	917-853-7064
Fax Number	:	718-302-3835

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICKI BARNETT
Credential	:	PHD
Telephone Number	:	917-853-7064

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	08/22/2020

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