Provider Demographics
NPI:1679649628
Name:ERNER, BARRY STEVEN (DO)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:STEVEN
Last Name:ERNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 KING ST
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3448
Mailing Address - Country:US
Mailing Address - Phone:914-238-1205
Mailing Address - Fax:914-238-1237
Practice Address - Street 1:121 KING ST
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3448
Practice Address - Country:US
Practice Address - Phone:914-238-1205
Practice Address - Fax:914-238-1237
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167104-1204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBE002E8710Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NYE03544Medicare UPIN