Provider Demographics
NPI:1720110653
Name:BARNETT, BRIGITTE MICHELE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:MICHELE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2526
Mailing Address - Country:US
Mailing Address - Phone:631-732-0700
Mailing Address - Fax:631-732-9046
Practice Address - Street 1:1312 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2526
Practice Address - Country:US
Practice Address - Phone:631-732-0700
Practice Address - Fax:631-732-9046
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ54701Medicare PIN