| Doctor Name: | MRS. BARI LYNN TANNENBAUM |
| NPI Number: | 1053541375 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 038065-1 |
| Business Practice Address: | 50 W Hawthorne Ave Valley Stream, NY - 115806220 |
| Business Phone Number: | 5165696600 |
| Business Fax Number: | |
| Mailing Address: | 73 Irma Dr, OCEANSIDE |
| State: | NY |
| Postal Code: | 115725715 |
| Phone Number: | 5167642967 |
| Fax Number: | |
| NPI Enumeration Date: | 07/21/2009 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 038065-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |