Provider Demographics
NPI:1295732196
Name:BARILLI, DAWN (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:BARILLI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1619
Mailing Address - Country:US
Mailing Address - Phone:845-783-2920
Mailing Address - Fax:
Practice Address - Street 1:503 ROUTE 208
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1619
Practice Address - Country:US
Practice Address - Phone:845-783-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-01-30
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2007-10-11
Provider Licenses
StateLicense IDTaxonomies
NY0067671363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0F3241Medicare PIN
NYS78602Medicare UPIN