Michael Vincent Pantalon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

002123 Issued in CT

Practice address

234 Church St
Suite 301
New Haven, CT 06510-1804

Phone

(203) 506-3134

Fax

(203) 244-4239

NPI assigned

Nov 6, 2009

Last updated

Nov 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Franklin Medical Group, PC

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1780686964
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1912234238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 CHURCH ST",
            "address_2": "SUITE 301",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101804",
            "telephone_number": "203-506-3134",
            "fax_number": "203-244-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CHURCH ST",
            "address_2": "SUITE 301",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101804",
            "telephone_number": "203-506-3134",
            "fax_number": "203-244-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTALON",
        "first_name": "MICHAEL",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002123",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "002123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Marie Panico, OTR/L, CHT
• Jose Manuel Panisello, MD
• Reema Panjwani, MD
• Dennis Domenic Pannella Sr., CRNA APRN
• Gauri Ganesh Panse, M.D.
• Haddon Jacob Pantel, M.D.
• Kristen Meyer Panthagani, MD, PHD
• Farzana Darayus Panthaky, L.AC.
• Wayne Panullo, M.D.
• Naomi Panza, LCSW

• Psychologist in New Haven, CT
• Providers in New Haven, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.