Provider Demographics
NPI:1750546891
Name:BARIATRIC ASSOCIATES OF NEW ENGLAND LLC
Entity type:Organization
Organization Name:BARIATRIC ASSOCIATES OF NEW ENGLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TAFURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-786-5007
Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-786-5007
Mailing Address - Fax:
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-786-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1006X, 163WD0400X
CT027231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V9144OtherHEALTHNET
CT2V9144OtherHEALTHNET
B83754Medicare UPIN
CTP00402236Medicare PIN