Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 001006CT01 | CT |
NPI | 1558561340 |
---|---|
Provider Name | Dr. Kevin R Barry |
First Address | West Hartford, CT 06117-2598 |
Second Address | West Hartford, CT 06117-2598 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 20/07/2007 |