Provider Demographics
NPI:1578634085
Name:BARRETTA, JANET SUE (LPT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:SUE
Last Name:BARRETTA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 MAUNAWILI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4629
Mailing Address - Country:US
Mailing Address - Phone:808-261-2309
Mailing Address - Fax:
Practice Address - Street 1:155 HAMAKUA DR STE B
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2849
Practice Address - Country:US
Practice Address - Phone:808-261-8931
Practice Address - Fax:808-261-0301
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHKPTMedicare ID - Type Unspecified