Provider Demographics
NPI:1396166609
Name:CAREY-SHAW, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:CAREY-SHAW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9760
Mailing Address - Country:US
Mailing Address - Phone:516-241-3276
Mailing Address - Fax:
Practice Address - Street 1:1 ASTOR AVE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11719-9760
Practice Address - Country:US
Practice Address - Phone:516-241-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-05
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012537-1103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVB8692Medicaid