Provider Demographics
NPI:1093787319
Name:BARRETT, JOSEPHINE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 ANTHONY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1403
Mailing Address - Country:US
Mailing Address - Phone:585-924-2100
Mailing Address - Fax:585-924-5920
Practice Address - Street 1:6532 ANTHONY DR STE A
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1422
Practice Address - Country:US
Practice Address - Phone:585-924-2100
Practice Address - Fax:585-398-1217
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02190141Medicaid
NYRB4187Medicare PIN
H15302Medicare UPIN