Individual
ROBERT BARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC 31639
Contact information
Practice address
4818 43RD ST, WOODSIDE, NY 11377-6845
(646) 464-5170
Mailing address
4818 43RD ST, WOODSIDE, NY 11377-6845
(646) 464-5170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31639
NY
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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