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Provider Information for 1235380338

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

BARRY CLYDE GEENBAUM

Other Name:   BARRY GREENBAUM
Gender: MALE

Individual NPI: 1235380338

Calendar   Last Updated:  2008-10-07
  Certification Date: 

Details

Name Value
NPI 1235380338
Enumeration Date 2008-10-07
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 555 KAPPOCK STREET
BRONX, NY 10463
United States

Phone: 718-549-8765 | Fax:
View Map External Link
Primary Practice Address 555 KAPPOCK ST APT 4P
BRONX, NY 10463-6403
United States

Phone: 718-549-8765 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 111N00000X - Chiropractor NY X002434