Healthcare Provider Details

I. General information

NPI: 1386553188
Provider Name (Legal Business Name): THOMAS BARRETT MICP, FPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 TALMADGE RD FLOOR 2
EDISON NJ
08817
US

IV. Provider business mailing address

308 TALMADGE RD FLOOR 2
EDISON NJ
08817
US

V. Phone/Fax

Practice location:
  • Phone: 732-375-4897
  • Fax:
Mailing address:
  • Phone: 732-375-4897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number4513
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: