Basic Information
| Provider Information | |||||||||
| NPI: | 1013987098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARSE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 266 MARVELWOOD DR | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065152449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038655111 | ||||||||
| FaxNumber: | 2035622368 | ||||||||
| Practice Location | |||||||||
| Address1: | 1450 CHAPEL STREET | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037894044 | ||||||||
| FaxNumber: | 2037893007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 015305 | CT | N | Other Service Providers | Specialist | 207R00000X | 015305 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 015305 | 01 | CT | LICENSE NUMBER | OTHER |