Provider Demographics
NPI:1881035806
Name:GARATE, JESS IAN BARBASO (MASTER IN SPECIAL ED)
Entity Type:Individual
Prefix:MR
First Name:JESS IAN
Middle Name:BARBASO
Last Name:GARATE
Suffix:
Gender:M
Credentials:MASTER IN SPECIAL ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SAYBROOK ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6505
Mailing Address - Country:US
Mailing Address - Phone:347-465-0649
Mailing Address - Fax:
Practice Address - Street 1:3 SAYBROOK ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6505
Practice Address - Country:US
Practice Address - Phone:347-465-0649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737559131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist