Provider Demographics
NPI:1073789079
Name:BARREVELD, ANTJE MARIANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTJE
Middle Name:MARIANNE
Last Name:BARREVELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTJE
Other - Middle Name:MARIANNE
Other - Last Name:HERLYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2014 WASHINGTON STREET
Mailing Address - Street 2:DEPT OF ANESTHESIOLOGY
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-243-6298
Mailing Address - Fax:617-243-6184
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243523207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine