Healthcare Provider Details

I. General information

NPI: 1104072073
Provider Name (Legal Business Name): PATRICIA D. BARRY, PHD, APRN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 LINNARD RD
WEST HARTFORD CT
06107-1234
US

IV. Provider business mailing address

60 LINNARD RD
WEST HARTFORD CT
06107-1234
US

V. Phone/Fax

Practice location:
  • Phone: 860-231-8717
  • Fax: 860-231-7477
Mailing address:
  • Phone: 860-231-8717
  • Fax: 860-231-7477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA D BARRY
Title or Position: PRESIDENT
Credential: PHD
Phone: 860-231-8717