Healthcare Provider Details

I. General information

NPI: 1316689847
Provider Name (Legal Business Name): SEAN MORALES BITLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PARK ST
NEW HAVEN CT
06519-1109
US

IV. Provider business mailing address

34 PARK ST
NEW HAVEN CT
06519-1109
US

V. Phone/Fax

Practice location:
  • Phone: 631-316-4991
  • Fax:
Mailing address:
  • Phone: 631-316-4991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number84284
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number84284
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: