Provider Demographics
NPI:1699859371
Name:BARSANTI, PATRICIA LAURA (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LAURA
Last Name:BARSANTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SHAWNEE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-5803
Mailing Address - Country:US
Mailing Address - Phone:908-755-5400
Mailing Address - Fax:908-755-6979
Practice Address - Street 1:10 SHAWNEE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-5803
Practice Address - Country:US
Practice Address - Phone:908-755-5400
Practice Address - Fax:908-755-6979
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07478500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0102687Medicaid
NJ0102687Medicaid
NJI18077Medicare UPIN