Provider Demographics
NPI:1225809296
Name:BARRETTO, FRANK JR (CPS)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:BARRETTO
Suffix:JR
Gender:M
Credentials:CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 VIOLET ST
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-1150
Mailing Address - Country:US
Mailing Address - Phone:631-877-4147
Mailing Address - Fax:
Practice Address - Street 1:418 VIOLET ST
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-1150
Practice Address - Country:US
Practice Address - Phone:631-877-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYCPS-P-1967175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist