Provider Demographics
NPI:1790760932
Name:BARRON, BENJAMIN (DPT)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:BARRON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COMMERCE WAY
Mailing Address - Street 2:STE 120
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8200
Mailing Address - Country:US
Mailing Address - Phone:603-427-8066
Mailing Address - Fax:603-501-0495
Practice Address - Street 1:96 CALEF HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2224
Practice Address - Country:US
Practice Address - Phone:603-679-3700
Practice Address - Fax:603-679-3733
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7725696OtherAETNA
MAAA45429OtherHARVARD PILGRIM HEALTH CA
MA0000Y68413OtherBLUE CROSS BLUE SHIELD
MA8077207OtherCIGNA
MA470390OtherTUFTS
MAAA45429OtherHARVARD PILGRIM HEALTH CA