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NPI Code Detail

MEDICARE: DRS. BARAKE & GENOVA, LLC

MEDICARE: DRS. BARAKE & GENOVA, LLC
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
1207R00000XInternal Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DD6948OTHERMORAIL ROAD MEDICARE

General Provider Information

NPI Number : 1669516506
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRS. BARAKE & GENOVA, LLC
Provider Business Mailing Address
First Line : 232 S WOODS MILL RD
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-3417
Country : US
Telephone Number : 314-576-2490
Fax Number : 314-576-2473
Provider Business Practice Location Address
First Line : 225 CLARKSON RD
Second Line :
City : ELLISVILLE
State : MO
Zip : 63011-2278
Country : US
Telephone Number : 636-207-8880
Fax Number : 636-256-7797
Authorized Official
Title or Position : DIRECTOR
Name : RICK SONNE
Credential :
Telephone Number : 314-576-2490
Provider Enumeration Date : 02/16/2007
Last Update Date : 11/14/2007

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Directions to “DRS. BARAKE & GENOVA, LLC ” Practice Location

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