Provider Demographics
NPI:1528408663
Name:PROPICIUS BRAIN & SPINE LLC
Entity Type:Organization
Organization Name:PROPICIUS BRAIN & SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:SENATUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:860-904-3096
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-0010
Mailing Address - Country:US
Mailing Address - Phone:860-904-3096
Mailing Address - Fax:860-288-8671
Practice Address - Street 1:701 COTTAGE GROVE RD
Practice Address - Street 2:STE. E230
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3080
Practice Address - Country:US
Practice Address - Phone:860-904-3096
Practice Address - Fax:860-288-8671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty