Provider Demographics
NPI:1275689630
Name:BARNETT, DEBRA M (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:M
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:M
Other - Last Name:BIGELOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6 FORT ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4959
Mailing Address - Country:US
Mailing Address - Phone:617-479-0200
Mailing Address - Fax:617-471-2157
Practice Address - Street 1:6 FORT ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4959
Practice Address - Country:US
Practice Address - Phone:617-479-0200
Practice Address - Fax:617-471-2157
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0366021Medicaid
MA0366021Medicaid
MABAY6419Medicare ID - Type Unspecified