Provider Demographics
NPI:1669660569
Name:ANTHONY R BARRI MD PC
Entity Type:Organization
Organization Name:ANTHONY R BARRI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:BARRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-445-2461
Mailing Address - Street 1:489 ROUTE 184
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6227
Mailing Address - Country:US
Mailing Address - Phone:860-445-2461
Mailing Address - Fax:860-445-8512
Practice Address - Street 1:489 GOLD STAR HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6227
Practice Address - Country:US
Practice Address - Phone:860-445-2461
Practice Address - Fax:860-445-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTA16685207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001166859Medicaid
CT0143100001Medicare NSC
CTC00834Medicare PIN