Provider Demographics
NPI:1043493364
Name:BARRAGATO, MARY JANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JANE
Last Name:BARRAGATO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:W HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9731
Mailing Address - Country:US
Mailing Address - Phone:585-359-1892
Mailing Address - Fax:
Practice Address - Street 1:55 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:W HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9731
Practice Address - Country:US
Practice Address - Phone:585-359-1892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467975163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse