Provider Demographics
NPI:1255882809
Name:BARRETTA, ALEXIS (RN)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:
Last Name:BARRETTA
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 1:9601 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND PATENT
Mailing Address - State:NY
Mailing Address - Zip Code:13354-4618
Mailing Address - Country:US
Mailing Address - Phone:315-865-7266
Mailing Address - Fax:315-865-7284
Practice Address - Street 1:8900 STATE ROUTE 365
Practice Address - Street 2:
Practice Address - City:STITTVILLE
Practice Address - State:NY
Practice Address - Zip Code:13469
Practice Address - Country:US
Practice Address - Phone:315-865-7266
Practice Address - Fax:315-865-7284
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702721-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool