Provider Demographics
NPI:1669431904
Name:BARKOFF, NEAL DAVID (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:DAVID
Last Name:BARKOFF
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:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-0230
Mailing Address - Country:US
Mailing Address - Phone:860-633-8806
Mailing Address - Fax:860-657-3788
Practice Address - Street 1:124 HEBRON AVE STE 1B
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2066
Practice Address - Country:US
Practice Address - Phone:860-633-8806
Practice Address - Fax:860-657-3788
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0299912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001299917Medicaid
CT010029991CT13OtherANTHEM BC/BS
CT300117745OtherRAILROAD MEDICARE
CT010029991CT03OtherANTHEM BC/BS
CT010029991CT06OtherANTHEM BC/BS
CT010029991CT04OtherANTHEM BC/BS
CT300042206OtherRAILROAD MEDICARE
CT300060086OtherRAILROAD MEDICARE
CT300095814OtherRAILROAD MEDICARE
CT300102712OtherRAILROAD MEDICARE
CT300117765OtherRAILROAD MEDICARE
CT010029991CT12OtherANTHEM BC/BS
CT300003019Medicare ID - Type Unspecified
CT300003135Medicare PIN
CT300117745OtherRAILROAD MEDICARE
CTE27157Medicare UPIN
CT001299917Medicaid
CT300060086OtherRAILROAD MEDICARE
CT300102712OtherRAILROAD MEDICARE