Healthcare Provider Details

I. General information

NPI: 1225642689
Provider Name (Legal Business Name): NICOLE BARATTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 FROM RD STE 420
PARAMUS NJ
07652-3551
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 201-972-8963
  • Fax: 201-972-8985
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01953400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: