Provider Demographics
NPI:1437109261
Name:BARIN, VLADIMIR
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:BARIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4238
Mailing Address - Country:US
Mailing Address - Phone:617-782-5100
Mailing Address - Fax:617-782-5122
Practice Address - Street 1:556 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2496
Practice Address - Country:US
Practice Address - Phone:617-782-5100
Practice Address - Fax:617-782-5122
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2009-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3757360OtherCIGNA
MA110030600/AMedicaid
MA7897681OtherAETNA
MAAA112184OtherHARVARD
MAY37002OtherBLUECROSS BLUESHIELD
MAY45540Medicare PIN