1043350317 NPI number — MS. ANNE MARIE BARRETT MS RN CS

Table of content: ALYSSA BARTLETT PHARM.D (NPI 1497130991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043350317 NPI number — MS. ANNE MARIE BARRETT MS RN CS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRETT
Provider First Name:
ANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS RN CS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043350317
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 870185
Provider Second Line Business Mailing Address:
71 ADAMS ST
Provider Business Mailing Address City Name:
MILTON VILLAGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02187-0185
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-429-5011
Provider Business Mailing Address Fax Number:
617-506-8779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 ADAMS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02186-3431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-429-5011
Provider Business Practice Location Address Fax Number:
617-506-8779
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0809X , with the licence number:  RN137948 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NS039501 . This is a "PTAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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