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General NPI Number Information
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NPI Number | 1790766368
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Entity Type | Individual
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Provider Name | ASIM F TARABAR MD
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 950 CAMPBELL AVENUE VA CONNECTICUT HEALTHCARE SYSTEM
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City | WEST HAVEN
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State | CT
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Zip | 06516
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Country | US
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Telephone | 203-932-5711
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Fax | 203-937-3474
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Provider Business Mailing Address
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Address Line | 20 YORK ST YALE NEW HAVEN HOSPITAL
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City | NEW HAVEN
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State | CT
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Zip | 06510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 038652
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | CT038652
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License Number State | CT
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