Basic Information
| Provider Information | |||||||||
| NPI: | 1962676049 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ARNAOUT | ||||||||
| FirstName: | BACHAAR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 CAMPBELL AVE | ||||||||
| Address2: | BUILDING 1, 8TH FLOOR, EAST WING | ||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065162770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
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| Practice Location | |||||||||
| Address1: | 950 CAMPBELL AVE | ||||||||
| Address2: | BUILDING 1, 8TH FLOOR, EAST WING | ||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065162770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2008 | ||||||||
| LastUpdateDate: | 10/10/2012 | ||||||||
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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 | 2084P0800X | 045237 | CT | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0802X | 045237 | CT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry | 208D00000X | 045237 | CT | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 008024427 | 05 | CT | MEDICAID | 008016167 | 05 | CT | MEDICAID | 008023170 | 05 | CT | MEDICAID |