Provider Demographics
NPI:1063775484
Name:BARRETT, RENEE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ELIZABETH
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:ELIZABETH
Other - Last Name:MOBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:DEPT OF NEONATAL-PERINATAL MEDICINE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:313-598-4971
Mailing Address - Fax:
Practice Address - Street 1:1101 W UNIVERSITY DR FL 2
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1863
Practice Address - Country:US
Practice Address - Phone:248-652-5331
Practice Address - Fax:248-652-5748
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054368208000000X
MI4301510167208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics