Provider Demographics
NPI:1003018292
Name:BARONE, MICHAEL ROBERT JR (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:BARONE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 HARTFORD TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3039
Mailing Address - Country:US
Mailing Address - Phone:203-281-5987
Mailing Address - Fax:
Practice Address - Street 1:1700 DIXWELL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3147
Practice Address - Country:US
Practice Address - Phone:203-288-7300
Practice Address - Fax:203-288-9775
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000627111N00000X
CT627111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU74760Medicare UPIN