Provider Demographics
NPI:1124219621
Name:BARRETO, FELICIA A (MD)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:A
Last Name:BARRETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:A
Other - Last Name:FREILICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:STE 1004
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-9600
Practice Address - Fax:508-973-9605
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA240049207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084088AMedicaid
RIFF78551Medicaid
MA001274801Medicare PIN