Provider Demographics
NPI:1689631319
Name:BARATTA, ANTHONY V JR (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:V
Last Name:BARATTA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 RIDGEWAY AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4145
Mailing Address - Country:US
Mailing Address - Phone:585-720-1550
Mailing Address - Fax:585-720-1553
Practice Address - Street 1:2440 RIDGEWAY AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4145
Practice Address - Country:US
Practice Address - Phone:585-720-1550
Practice Address - Fax:585-720-1553
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1813341207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010181334OtherBCHOICE
NY02214OtherBCBSH
NY0005100246OtherAETNA PIN
NY101319BTOtherPREFERRED CARE
NY161420119OtherUNITED HEALTHCARE
NY01382796Medicaid
NY161420119OtherAETNA