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General NPI Number Information
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NPI Number | 1063428878
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Entity Type | Individual
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Provider Name | DOMENICA MARIA BARRITTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 18 OLIVER ST
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City | NEWARK
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State | NJ
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Zip | 07102-3410
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Country | US
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Telephone | 973-645-0000
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Fax | 973-645-0001
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Provider Business Mailing Address
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Address Line | PO BOX 2337
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City | SYRACUSE
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State | NY
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Zip | 13220-2337
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Country | US
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Telephone | 315-422-2933
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Fax | 315-701-5608
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25MA07669400
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License Number State | NJ
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