Provider Demographics
NPI:1639309362
Name:BARNABAS, RUANNE VANESSA (MBCHB, DPHIL)
Entity Type:Individual
Prefix:DR
First Name:RUANNE
Middle Name:VANESSA
Last Name:BARNABAS
Suffix:
Gender:F
Credentials:MBCHB, DPHIL
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2696
Mailing Address - Country:US
Mailing Address - Phone:206-617-7243
Mailing Address - Fax:617-726-3755
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-3467
Practice Address - Fax:617-726-3755
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60281820207RI0200X
WATR60178451207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1639309362Medicaid