Provider Demographics
NPI:1164057568
Name:PAIN MANAGEMENT PARTNERS LLC
Entity Type:Organization
Organization Name:PAIN MANAGEMENT PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPRAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-885-1441
Mailing Address - Street 1:7 OLD SHERMAN TPKE STE 209
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4174
Mailing Address - Country:US
Mailing Address - Phone:203-885-1441
Mailing Address - Fax:475-329-2283
Practice Address - Street 1:10 BIRDSEYE RD STE 260
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2489
Practice Address - Country:US
Practice Address - Phone:860-606-7557
Practice Address - Fax:860-404-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty