Provider Demographics
NPI:1497795314
Name:RICHTER, BARRY J (MD, PC)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:RICHTER
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:DR
Other - First Name:BARRY
Other - Middle Name:J
Other - Last Name:RICHTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5 DURHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437
Mailing Address - Country:US
Mailing Address - Phone:203-453-6166
Mailing Address - Fax:203-453-9747
Practice Address - Street 1:5 DURHAM ROAD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:203-453-6166
Practice Address - Fax:203-453-9747
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTA22802207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010022802CT01OtherBLUE CROSS
0304336OtherUNITED HEALTH CARE
B37810Medicare UPIN
070000117Medicare ID - Type Unspecified
070000133Medicare ID - Type UnspecifiedRR MEDICARE