Basic Information
| Provider Information | |||||||||
| NPI: | 1003018292 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARONE | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1021 HARTFORD TPKE | ||||||||
| Address2: | |||||||||
| City: | NORTH HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064733039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032815987 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1700 DIXWELL AVE | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065143147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032887300 | ||||||||
| FaxNumber: | 2032889775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 05/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 000627 | CT | N | Chiropractic Providers | Chiropractor | 111NN0400X | 627 | CT | Y | Chiropractic Providers | Chiropractor | Neurology |
No ID Information.