Provider Demographics
NPI:1801867882
Name:BARRETT, KATHLEEN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:274 MADISON AVE
Mailing Address - Street 2:ROOM 605
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0701
Mailing Address - Country:US
Mailing Address - Phone:212-532-8278
Mailing Address - Fax:212-532-7021
Practice Address - Street 1:274 MADISON AVE
Practice Address - Street 2:ROOM 605
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0701
Practice Address - Country:US
Practice Address - Phone:212-532-8278
Practice Address - Fax:212-532-7021
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005361213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPWW741Medicare ID - Type Unspecified
NYU66603Medicare UPIN
NY5529480001Medicare NSC