Provider Demographics
NPI:1174778591
Name:BARATTA, DAWN MARIE (PT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:BARATTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 HUGHES PL
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1601
Mailing Address - Country:US
Mailing Address - Phone:516-750-5216
Mailing Address - Fax:516-465-3719
Practice Address - Street 1:149 HUGHES PL
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1601
Practice Address - Country:US
Practice Address - Phone:516-750-5216
Practice Address - Fax:516-465-3719
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018084-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency