Healthcare Provider Details
I. General information
NPI: 1114462751
Provider Name (Legal Business Name): ALMA ROSA BARRETO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/05/2017
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
65 AVONWOOD RD APT C9
AVON CT
06001-2051
US
IV. Provider business mailing address
401 W THAMES ST BLDG 301
NORWICH CT
06360-7155
US
V. Phone/Fax
- Phone: 203-559-6525
- Fax:
- Phone: 860-859-4674
- Fax: 860-859-4797
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | 6900 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 6900 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 6900 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: