Provider Demographics
NPI:1316068810
Name:BARRETT RAGKASWAR, MARLENE
Entity type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:
Last Name:BARRETT RAGKASWAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5814
Mailing Address - Country:US
Mailing Address - Phone:516-612-4400
Mailing Address - Fax:516-612-4399
Practice Address - Street 1:31 E MERRICK RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5814
Practice Address - Country:US
Practice Address - Phone:516-612-4400
Practice Address - Fax:516-612-4399
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013891-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0029050OtherORTHONET
NY0029050OtherHEALTHNET
NY0029050OtherCIGNA
123260OtherGHI HMO
NY02940641Medicaid
NY0182434OtherGHI PPO
NYA400020014Medicare PIN