Provider Demographics
NPI:1730150855
Name:ELSON, BARRY D (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:ELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3914
Mailing Address - Country:US
Mailing Address - Phone:413-584-7787
Mailing Address - Fax:413-584-7778
Practice Address - Street 1:395 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3914
Practice Address - Country:US
Practice Address - Phone:413-584-7787
Practice Address - Fax:413-584-7778
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45090207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA50481Medicare UPIN
MAG22003Medicare ID - Type Unspecified