Provider Demographics
NPI:1154323780
Name:BARILETTI, VALERIO FRANK (MD)
Entity Type:Individual
Prefix:
First Name:VALERIO
Middle Name:FRANK
Last Name:BARILETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ROUTE 59
Mailing Address - Street 2:UNIT B2
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5005
Mailing Address - Country:US
Mailing Address - Phone:845-357-8660
Mailing Address - Fax:845-357-9170
Practice Address - Street 1:156 RT 59
Practice Address - Street 2:UNIT B2
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-6511
Practice Address - Country:US
Practice Address - Phone:845-357-8660
Practice Address - Fax:845-357-9170
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167433-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01134463Medicaid
NY22E301OtherBC/BS
NYWANG21Medicare PIN
C55222Medicare UPIN