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Individual

DR. EDWARD JOHN BARNOSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
77 MEDFORD AVE STE D, PATCHOGUE, NY 11772-1230
(631) 366-3369
(631) 366-3369
Mailing address
77 MEDFORD AVE STE D, PATCHOGUE, NY 11772-1230
(631) 366-3369
(631) 366-2043

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
011687-1
NY
103TC0700X
Clinical Psychologist
011687-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01503557
NY
Enumeration date
07/11/2006
Last updated
10/20/2011
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