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General NPI Number Information
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NPI Number | 1619029469
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Entity Type | Individual
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Provider Name | DR. RICHARD BARANELLO
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 533 E PUTNAM AVE
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City | COS COB
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State | CT
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Zip | 06807-2506
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Country | US
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Telephone | 203-661-5777
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Fax | 203-661-9545
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Provider Business Mailing Address
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Address Line | 533 E PUTNAM AVE
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City | COS COB
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State | CT
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Zip | 06807-2506
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Country | US
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Telephone | 203-661-5777
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Fax | 203-661-9545
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8536
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License Number State | CT
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