Provider Demographics
NPI:1023094133
Name:BARCHINI, GEORGE MEHRIZ
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MEHRIZ
Last Name:BARCHINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1740
Mailing Address - Country:US
Mailing Address - Phone:860-283-6255
Mailing Address - Fax:860-283-6202
Practice Address - Street 1:205 S MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1740
Practice Address - Country:US
Practice Address - Phone:860-283-6255
Practice Address - Fax:860-283-6202
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001331760Medicaid