Provider Demographics
NPI:1871681163
Name:BARATTA, JOSEPH BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BENJAMIN
Last Name:BARATTA
Suffix:
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 1:805 PEACH TREE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2300
Mailing Address - Country:US
Mailing Address - Phone:201-563-5372
Mailing Address - Fax:201-847-8298
Practice Address - Street 1:805 PEACH TREE LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2300
Practice Address - Country:US
Practice Address - Phone:201-563-5372
Practice Address - Fax:201-847-8298
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04531900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6423108Medicaid
NY01639394Medicaid
167154Medicare PIN
NY01639394Medicaid