Provider Demographics
NPI:1831464221
Name:BARRETT, THERESA M (RN)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 144TH ST
Mailing Address - Street 2:JAMAICA
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3103
Mailing Address - Country:US
Mailing Address - Phone:718-657-1120
Mailing Address - Fax:
Practice Address - Street 1:8505 144TH ST
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-3103
Practice Address - Country:US
Practice Address - Phone:718-657-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252879-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool