Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | N006134 | NY |
N | 213ES0103X | Foot & Ankle Surgery | N006134 | NY |
Y | 213ES0131X | Foot Surgery | N006134 | NY |
NPI | 1225026727 |
---|---|
Provider Name | Dr. Kelvin A Barry SR. |
First Address | Brooklyn, NY 11236-5428 |
Second Address | Jackson Heights, NY 11372-7968 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02882406 | (05) | NY |
N006134 | NEW YORK STATE LICENSE (01) | NY |
V12297 | (02) |