Provider Demographics
NPI:1861587057
Name:CAROL A. BARRETTE, M.D. P.C.
Entity type:Organization
Organization Name:CAROL A. BARRETTE, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARRETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-363-6868
Mailing Address - Street 1:113 S SHORE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-3341
Mailing Address - Country:US
Mailing Address - Phone:508-943-0623
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 550
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-363-6868
Practice Address - Fax:508-363-6866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78275174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA637717OtherTUFTS HEALTH PLAN
MA67582OtherFALLON
MA9729950Medicaid
MAM18303OtherBLUE SHIELD OF MA
MA9729950Medicaid