Provider Demographics
NPI:1972636850
Name:BARRINGTON PEDIATRIC ASSOCIATES, INC.
Entity type:Organization
Organization Name:BARRINGTON PEDIATRIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:D
Authorized Official - Last Name:LERISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-247-1640
Mailing Address - Street 1:334 COUNTY RD STE D
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2430
Mailing Address - Country:US
Mailing Address - Phone:401-247-2288
Mailing Address - Fax:401-247-2960
Practice Address - Street 1:334 COUNTY RD STE D
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-2430
Practice Address - Country:US
Practice Address - Phone:401-247-2288
Practice Address - Fax:401-247-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBP00925Medicaid