Provider Demographics
NPI:1326225525
Name:BARRY W HAIGHT MD
Entity Type:Organization
Organization Name:BARRY W HAIGHT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:M
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:COE
Authorized Official - Phone:860-872-7325
Mailing Address - Street 1:351 MERLINE RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 MERLINE RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4040
Practice Address - Country:US
Practice Address - Phone:860-872-7325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001588332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001171735Medicaid
CT001171735Medicaid
CT1234680001Medicare NSC
CT180000191Medicare PIN