Provider Demographics
NPI:1073517850
Name:BUGLIARI, RICHARD ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALEXANDER
Last Name:BUGLIARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1062 BARNES RD
Mailing Address - Street 2:STE 300
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2576
Mailing Address - Country:US
Mailing Address - Phone:203-265-9831
Mailing Address - Fax:203-265-2977
Practice Address - Street 1:1062 BARNES RD
Practice Address - Street 2:STE 300
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2576
Practice Address - Country:US
Practice Address - Phone:203-265-9831
Practice Address - Fax:203-265-2977
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026682207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001266824Medicaid
B83934Medicare UPIN
CT001266824Medicaid