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General NPI Number Information
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NPI Number | 1821959784
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Entity Type | Individual
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Provider Name | LARRY THOMAS BARETTE JR. RN, BSN, PCCN
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Gender | Male
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 800 ARCHER RD
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City | BEDFORD
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State | OH
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Zip | 44146-2927
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Country | US
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Telephone | 845-392-2976
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Fax |
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Provider Business Mailing Address
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Address Line | 800 ARCHER RD
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City | BEDFORD
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State | OH
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Zip | 44146-2927
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Country | US
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Telephone |
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Fax |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 479738
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License Number State | OH
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