Provider Demographics
NPI:1285617217
Name:BARRETO, SUZETTE VALERIANO (MD)
Entity type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:VALERIANO
Last Name:BARRETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1723-25 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3133
Mailing Address - Country:US
Mailing Address - Phone:610-253-7211
Mailing Address - Fax:610-252-8685
Practice Address - Street 1:3735 NAZARETH RD STE 301
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8347
Practice Address - Country:US
Practice Address - Phone:610-829-2200
Practice Address - Fax:610-829-2211
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056527L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018601410002Medicaid
PA03020100OtherBC
PA1514975OtherGATEWAY
PA0369324OtherBLUE SHIELD
G20714Medicare UPIN
PA016364Medicare PIN