Provider Demographics
NPI:1326419086
Name:BARLETTA, PATRICIA (MS PA)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:BARLETTA
Suffix:
Gender:F
Credentials:MS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 HUNTING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041-8728
Mailing Address - Country:US
Mailing Address - Phone:315-263-4525
Mailing Address - Fax:
Practice Address - Street 1:4214 HUNTING CREEK DR
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041-8728
Practice Address - Country:US
Practice Address - Phone:315-263-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019186363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant