Provider Demographics
NPI:1437368438
Name:RICHARD A. BARTLETT, MD, PC
Entity Type:Organization
Organization Name:RICHARD A. BARTLETT, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-735-1800
Mailing Address - Street 1:77 POND AVE
Mailing Address - Street 2:SUITE104-C
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7141
Mailing Address - Country:US
Mailing Address - Phone:617-735-1800
Mailing Address - Fax:617-735-1810
Practice Address - Street 1:77 POND AVE
Practice Address - Street 2:SUITE 104C
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7141
Practice Address - Country:US
Practice Address - Phone:617-735-1800
Practice Address - Fax:617-735-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA738172086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9748920Medicaid
MA9748920Medicaid
MAE76600Medicare UPIN