Provider Demographics
NPI:1912009655
Name:HAO, RITCHE MANOS (MD)
Entity Type:Individual
Prefix:
First Name:RITCHE
Middle Name:MANOS
Last Name:HAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4405
Mailing Address - Country:US
Mailing Address - Phone:203-789-4135
Mailing Address - Fax:203-867-5241
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-789-4135
Practice Address - Fax:203-867-5241
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049258207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132190100Medicaid
MD411895200Medicaid
MD411895200Medicaid
MD211864Medicare Oscar/Certification
MDK802Medicare PIN
MDI69122Medicare UPIN
MD132190100Medicaid