Healthcare Provider Details

I. General information

NPI: 1144883034
Provider Name (Legal Business Name): JOHN BARRETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W 168TH ST APT 38
NEW YORK NY
10032-3711
US

IV. Provider business mailing address

47 WASHINGTON AVE
DANBURY CT
06810-7926
US

V. Phone/Fax

Practice location:
  • Phone: 203-826-4914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number322488
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number322488
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: