Provider Demographics
NPI:1588803910
Name:BARRETT, EBONY ANNETTE (PNP)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:ANNETTE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3800
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:WINTHROP UNIVERSITY HOSPITAL, NICU
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-3853
Practice Address - Fax:516-663-8955
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381917-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics