Provider Demographics
NPI:1538189352
Name:BARAN, PATRICIA MARIA (MS-CCC-A)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIA
Last Name:BARAN
Suffix:
Gender:F
Credentials:MS-CCC-A
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:MARIA
Other - Last Name:KOPYLCZAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2870 COUNTY ROUTE 91
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9651
Mailing Address - Country:US
Mailing Address - Phone:315-677-3899
Mailing Address - Fax:
Practice Address - Street 1:1001 VINE SREET
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088
Practice Address - Country:US
Practice Address - Phone:315-451-7221
Practice Address - Fax:315-457-1223
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001475231H00000X
NY14000004107237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC3364Medicare ID - Type Unspecified