Organization Active NPI

Barry Reisberg, MD, PC

  • Adult Mental Health Clinic/Center
  • New York, NY
National Provider Identifier
1013385376
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BARRY REISBERG, MD, PC
Practice address
20 Waterside Plaza
7K
New York, NY 10010-2619
Phone
(212) 889-7579
Fax
(212) 263-6991
NPI assigned
Sep 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Barry Reisberg, M.D.
Title
President
Phone
(212) 889-7579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

20 Waterside Plaza
7K
New York, NY 10010-2619

Mailing address

20 Waterside Plaza
7K
New York, NY 10010-2619
Phone (212) 889-7579

Other identifiers 1

IdentifierTypeStateIssuer
MD00563713MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1013385376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WATERSIDE PLAZA",
            "address_2": "7K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102619",
            "telephone_number": "212-889-7579",
            "fax_number": "212-263-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WATERSIDE PLAZA",
            "address_2": "7K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102619",
            "telephone_number": "212-889-7579",
            "fax_number": "212-263-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY REISBERG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "REISBERG",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-889-7579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD00563713",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.