Individual
ANTHONY J BARRAVECCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
510 HAMBURG TPKE, WAYNE COMMONS, SUITE 101, WAYNE, NJ 07470-2025
(973) 942-6005
(973) 942-6009
Mailing address
510 HAMBURG TPKE, WAYNE COMMONS, SUITE 101, WAYNE, NJ 07470-2025
(973) 942-6005
(973) 942-6009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB06978600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080180176
RAILROAD MDCR #
NJ
01
—
1K8291
HEALTHNET #
NJ
01
—
2016613000
AMERIHEALTH ID#
NJ
01
—
2586866
AETNA HMO #
NJ
01
—
5716972
GHI PPO #
NJ
01
—
6R2921
EMPIRE BC/BS #
NJ
01
—
7678228
AETNA PPO #
NJ
05
—
8643903
—
NJ
01
—
P2010902
OXFORD ID#
NJ
Enumeration date
03/17/2006
Last updated
04/04/2013
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