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General NPI Number Information
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NPI Number | 1164518361
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Entity Type | Organization
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Legal Business Name | BAROCHIA INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 66 CEDAR ST SUITE 105
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City | NEWINGTON
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State | CT
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Zip | 06111-2633
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Country | US
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Telephone | 860-667-8200
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Fax | 860-667-8202
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Provider Business Mailing Address
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Address Line | 66 CEDAR ST SUITE 105
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City | NEWINGTON
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State | CT
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Zip | 06111-2633
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Country | US
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Telephone | 860-667-8200
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Fax | 860-667-8202
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANJAY P BAROCHIA
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Credential | M.D.
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Telephone | 860-667-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 041851
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License Number State | CT
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