Basic Information
| Provider Information | |||||||||
| NPI: | 1407823966 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDING | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 256 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060422004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606468595 | ||||||||
| FaxNumber: | 8606453216 | ||||||||
| Practice Location | |||||||||
| Address1: | 256 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060422004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606468595 | ||||||||
| FaxNumber: | 8606453216 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2006 | ||||||||
| LastUpdateDate: | 06/07/2010 | ||||||||
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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 | 207R00000X | 028459 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 010028459CT02 | 01 | CT | ANTHEM BLUE CROSS | OTHER | 110176018 | 01 | CT | MEDICARE RAIL ROAD | OTHER | 001284596 | 05 | CT | MEDICAID | 1407823966 | 01 | NPI | OTHER |