Provider Demographics
NPI:1962609990
Name:BURKHARD, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:BURKHARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:BURKHARD
Other - Last Name:EBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:19 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-751-3971
Mailing Address - Fax:
Practice Address - Street 1:811 WEST JERICHO TURNPIKE
Practice Address - Street 2:SUITE 106E
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-265-9850
Practice Address - Fax:631-265-9852
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007538103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist