Provider Demographics
NPI:1760776165
Name:COUGHLIN, BARBARA FISHER (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:FISHER
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WAWARME AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-1509
Mailing Address - Country:US
Mailing Address - Phone:860-466-6297
Mailing Address - Fax:
Practice Address - Street 1:309 WAWARME AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1509
Practice Address - Country:US
Practice Address - Phone:860-466-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22910208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics