Healthcare Provider Details

I. General information

NPI: 1881745339
Provider Name (Legal Business Name): ROBERT JOSEPH TAFURI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ORCHARD STREET SUITE 402
NEW HAVEN CT
06511-3224
US

IV. Provider business mailing address

200 ORCHARD ST 402
NEW HAVEN CT
06511-5363
US

V. Phone/Fax

Practice location:
  • Phone: 203-786-5007
  • Fax: 203-786-5008
Mailing address:
  • Phone: 203-786-5007
  • Fax: 203-786-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number027231
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number027231
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: