Provider Demographics
NPI:1710932181
Name:BASCH-BARRIOS MD, PC
Entity Type:Organization
Organization Name:BASCH-BARRIOS MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-328-7159
Mailing Address - Street 1:965 BALTIMORE PIKE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3957
Mailing Address - Country:US
Mailing Address - Phone:610-328-7159
Mailing Address - Fax:610-328-9093
Practice Address - Street 1:965 BALTIMORE PIKE
Practice Address - Street 2:SUITE B3
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3957
Practice Address - Country:US
Practice Address - Phone:610-328-7159
Practice Address - Fax:610-328-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0031317001OtherKEYSTONE HMO ID
PA000405562Medicare PIN