Healthcare Provider Details

I. General information

NPI: 1649430109
Provider Name (Legal Business Name): BRYAN RICHARD BARRETT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE STE 909
EGG HARBOR TOWNSHIP NJ
08234-5587
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE STE 909
EGG HARBOR TOWNSHIP NJ
08234-5587
US

V. Phone/Fax

Practice location:
  • Phone: 609-407-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number25MB08951400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB08951400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: