MEDICARE: BRENDA B BARATTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	179630	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	110242023	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	051006000000	OTHER	NY	FIDELIS
3	P010179630	OTHER	NY	BCBS
5	00027338101	OTHER	NY	UNIVERA
6	106276BJ	OTHER	NY	PREFERRED CARE
7	11121547	OTHER	NY	CAQH

General Provider Information

NPI Number	:	1003874322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA B BARATTA MD

Provider Business Mailing Address
First Line	:	2021 WINTON RD S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3957
Country	:	US
Telephone Number	:	585-784-6400
Fax Number	:	585-341-2370

Provider Business Practice Location Address
First Line	:	2021 WINTON RD S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3957
Country	:	US
Telephone Number	:	585-784-6400
Fax Number	:	585-341-2370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/12/2016

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Directions to “ BRENDA B BARATTA MD” Practice Location

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