Zinaida Boutaeva, M.D.
Individual provider Active NPI Addiction Psychiatry Physician · Orange, CT
NPI 1154583748 · NPPES record last updated Jun 25, 2008
Key facts
- NPI
- 1154583748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Psychiatry Physician 2084P0802X
- License
- 046350 (CT)
- Practice address
- 6232 Avalon Dr W
Orange, CT 06477-3679 - Phone
- (203) 908-3138
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Health, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 046350 | CT | Yes |
Addresses
Primary practice location
6232 Avalon Dr W
Orange, CT 06477-3679
Mailing address
6232 Avalon Dr W
Orange, CT 06477-3679
Phone (203) 908-3138
Other providers in Orange, CT
- Bo Acupuncture Healing, LLC
- Julianne Boggs
- Rebecca Bonetti
- Patricia Borrelli
- Boston Brace International Inc.
- Meghan Bova
- Krisan Bradley
- Lauren Brickett
- Brighter Days Psychiatry, Inc
- Dorota Brynda-Hansen
All providers in Orange, CT · Addiction Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.