Provider Demographics
NPI:1265720163
Name:NEWINGTON BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:NEWINGTON BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:ARIMORO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-887-5950
Mailing Address - Street 1:93 ROCKLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5152
Mailing Address - Country:US
Mailing Address - Phone:203-887-5950
Mailing Address - Fax:866-514-0409
Practice Address - Street 1:1268 MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3038
Practice Address - Country:US
Practice Address - Phone:860-667-3965
Practice Address - Fax:866-514-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-13
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTAVRS 00800431Medicaid