Provider Demographics
NPI:1336581800
Name:MICHEL JEAN-BAPTISTE, MD, LLC
Entity Type:Organization
Organization Name:MICHEL JEAN-BAPTISTE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-397-5491
Mailing Address - Street 1:270 AMITY RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2236
Mailing Address - Country:US
Mailing Address - Phone:203-397-5491
Mailing Address - Fax:203-397-3537
Practice Address - Street 1:270 AMITY RD
Practice Address - Street 2:SUITE 132
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2236
Practice Address - Country:US
Practice Address - Phone:203-397-5491
Practice Address - Fax:203-397-3537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC00623Medicare PIN