Basic Information
Provider Information
NPI: 1558648055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRINGER
FirstName: SUSAN
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 45 CLARK ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065113801
CountryCode: US
TelephoneNumber: 2035506571
FaxNumber:  
Practice Location
Address1: 950 CAMPBELL AVE
Address2:  
City: WEST HAVEN
State: CT
PostalCode: 065162770
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/11/2011
LastUpdateDate: 11/11/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X004785CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


Home