Provider Demographics
NPI:1033564273
Name:BARATTA DERMATOLOGY LLC
Entity Type:Organization
Organization Name:BARATTA DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-235-0512
Mailing Address - Street 1:1299 ROUTE 38
Mailing Address - Street 2:STE 8
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2791
Mailing Address - Country:US
Mailing Address - Phone:609-288-6884
Mailing Address - Fax:609-667-7103
Practice Address - Street 1:1299 ROUTE 38
Practice Address - Street 2:STE 8
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2791
Practice Address - Country:US
Practice Address - Phone:609-288-6884
Practice Address - Fax:609-667-7103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07528000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty