Individual
MRS. KATHERINE B BARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
8 CANAL CT, AVON, CT 06001-3726
(860) 674-9686
(860) 674-9954
Mailing address
8 CANAL CT, AVON, CT 06001-3726
(860) 674-9686
(860) 674-9954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002520
CT
363A00000X
Physician Assistant
012667
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000418479001
BSNENY
NY
05
—
03046595
—
NY
01
—
080913000013
FIDELIS
NY
01
—
6020240
MVP HEALTHCARE
NY
Enumeration date
08/19/2008
Last updated
08/23/2016
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