Provider Demographics
NPI:1205086329
Name:BARAKAT, PIERRE G (MD)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:G
Last Name:BARAKAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JEAN-PIERRE
Other - Middle Name:GEORGES
Other - Last Name:BARAKAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20 MARBLE LOOP STE 2
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1353
Mailing Address - Country:US
Mailing Address - Phone:646-730-7132
Mailing Address - Fax:718-928-9134
Practice Address - Street 1:20 MARBLE LOOP STE 2A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1353
Practice Address - Country:US
Practice Address - Phone:646-730-7132
Practice Address - Fax:718-928-9134
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250159-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03055823Medicaid
NYA400083773OtherMEDICARE PTAN
NYA400010702OtherMEDICARE PTAN