Provider Demographics
NPI:1164518361
Name:BAROCHIA INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:BAROCHIA INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:BAROCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-667-8200
Mailing Address - Street 1:66 CEDAR ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2633
Mailing Address - Country:US
Mailing Address - Phone:860-667-8200
Mailing Address - Fax:860-667-8202
Practice Address - Street 1:66 CEDAR ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2633
Practice Address - Country:US
Practice Address - Phone:860-667-8200
Practice Address - Fax:860-667-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001418517Medicaid
CT001418517Medicaid
CTC03582Medicare PIN