MEDICARE: MRS. DAWN MARIE BARRETT

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	235Z00000X	Speech-Language Pathologist	010439-1	NY

General Provider Information

NPI Number	:	1851531131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN MARIE BARRETT

Provider Business Mailing Address
First Line	:	PO BOX 673
Second Line	:
City	:	SPARROW BUSH
State	:	NY
Zip	:	12780-0673
Country	:	US
Telephone Number	:	845-858-6278
Fax Number	:	845-858-6278

Provider Business Practice Location Address
First Line	:	303 WILSON RD
Second Line	:
City	:	SPARROW BUSH
State	:	NY
Zip	:	12780-5439
Country	:	US
Telephone Number	:	845-858-6278
Fax Number	:	845-858-6278

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

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	02/26/2009

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Directions to “ MRS. DAWN MARIE BARRETT ” Practice Location

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