PAIN & SPINE SPECIALISTS OF CONNECTICUT, LLC (NPI# 1528535119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528535119 |
| Entity Type | Organization |
| Organization Name | PAIN & SPINE SPECIALISTS OF CONNECTICUT, LLC |
| Practice Address |
5520 Park Ave Ste Wp2-200 Trumbull CT 06611-3463 |
| Mailing Address |
11350 Mccormick Rd Executive Plaza 1, Suite 501 Hunt Valley MD 21031 |
| Practice Telephone | 2037437264 |
| Practice Fax Number | 2037923920 |
| Mailing Telephone | 4103291071 |
| Mailing Fax Number | 4103291054 |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |
| Authorized Official Name | DAVID C LEVI (MEDICAL DOCTOR) |
| Authorized Official Telephone | 2037927246 |
| Is Organization Subpart | Y |
| Parent Organization Name | PAIN & SPINE SPECIALISTS OF CONNECTICUT, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256378 | Pain & Spine Specialists of Connecticut, LLC | Pain Medicine | 75 Kings Highway Cutoff Ste 3a, Fairfield, CT 06824-5340 | 2020-08-20 |
| 1235606880 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 1320 W Main St Bldg 2, Waterbury, CT 06708-3131 | 2018-10-31 |
| 1174826598 | Pain & Spine Specialists of Connecticut, LLC | Specialist | 131 Kent Rd Bldg A, New Milford, CT 06776-3485 | 2010-12-07 |
| 1467588020 | Pain & Spine Specialists of Connecticut, LLC | Pain Medicine | 67 Sandpit Rd, Suite 308, Danbury, CT 06810-4032 | 2007-02-26 |
| 1891262481 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | 2018-11-01 |
| 1700353398 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 11 South Rd Ste 250, Farmington, CT 06032-2484 | 2018-11-01 |
| 1346717931 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 131 Kent Rd Bldg A, New Milford, CT 06776-3485 | 2018-11-01 |
| 1467755900 | Pain & Spine Specialists of Connecticut, LLC | Specialist | 1320 W Main St, Bldg 2, Waterbury, CT 06708-3119 | 2010-12-06 |
| Street Address |
5520 PARK AVE STE WP2-200 |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073153326 | Justin Elijah Brantley | Physical Therapist | 888 White Plains Road Suite 209, Trumbull, CT 06611 | 2020-01-14 |
| 1184135733 | Stephen Graham | Speech-Language Pathologist | 126 Monroe Turnpike Suite #210, Trumbull, CT 06611 | 2017-10-22 |
| 1891214458 | Rachel Lopes | Social Worker | 132 Monroe Turnpike, 3rd Floor Suite 1, Trumbull, CT 06611 | 2017-09-14 |
| 1588193981 | James Geisler | Counselor | 23 Wilmot Ave., Trumbull, CT 06611 | 2017-06-08 |
| 1215463807 | Rodrigo Fernandez | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Avenue., Bridgeport Hospital Womens Health Care Center., Bridgeport, CT 06611 | 2017-05-03 |
| 1285087650 | Trumbull Pharmacy LLC | Pharmacy | 10 Broadway Road, Bldg B, Unit B, Trumbull, CT 06611 | 2016-07-20 |
| 1063897601 | Camilla Marie Schnaitmann | Social Worker | 132 Monroe Turnpike, Trumbull, CT 06611 | 2015-07-24 |
| 1194107318 | Alison R Kudish | Dentist | 160 Hawley Ln Ste 101, Trumbull, CT 06611 | 2015-06-24 |
| 1639456783 | Sagar Makanji | Pharmacist | 5065 Main Street, Ste Target, Target Pharmacy, Store 2361, Trumbull, CT 06611 | 2011-11-03 |
| 1639485956 | Beata Everett | Social Worker | 42 Craig Lane, Trumbull, CT 06611 | 2010-08-24 |
| Find all providers in zip 06611 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235606880 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 1320 W Main St Bldg 2, Waterbury, CT 06708-3131 | 2018-10-31 |
| 1891262481 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | 2018-11-01 |
| 1700353398 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 11 South Rd Ste 250, Farmington, CT 06032-2484 | 2018-11-01 |
| 1346717931 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 131 Kent Rd Bldg A, New Milford, CT 06776-3485 | 2018-11-01 |
| 1619323706 | Norwich Orthopedic Group, PC | Non-Pharmacy Dispensing Site | 11 Industrial Park Rd, Niantic, CT 06357-1904 | 2016-05-09 |
| 1407297203 | Norwalk Medical Group | Non-Pharmacy Dispensing Site | 24 Stevens St, Norwalk, CT 06850-3852 | 2013-07-10 |
| 1306103502 | Feel Well Health Center of Southington, PC | Non-Pharmacy Dispensing Site | 710 Main St, Bldg 4, Plantsville, CT 06479-1565 | 2012-04-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.