1710932181 NPI number — BASCH-BARRIOS MD, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710932181 NPI number — BASCH-BARRIOS MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BASCH-BARRIOS MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710932181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
965 BALTIMORE PIKE
Provider Second Line Business Mailing Address:
SUITE B3
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19064-3957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-328-7159
Provider Business Mailing Address Fax Number:
610-328-9093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
965 BALTIMORE PIKE
Provider Second Line Business Practice Location Address:
SUITE B3
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19064-3957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-328-7159
Provider Business Practice Location Address Fax Number:
610-328-9093
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARRIOS
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
LESLIE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-328-7159

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0031317001 . This is a "KEYSTONE HMO ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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