Provider Demographics
NPI:1558125708
Name:REGENERATIVE MEDICINE CONNECTICUT PLLC
Entity Type:Organization
Organization Name:REGENERATIVE MEDICINE CONNECTICUT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-841-7339
Mailing Address - Street 1:10 WHITTIER RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5236
Mailing Address - Country:US
Mailing Address - Phone:202-841-7339
Mailing Address - Fax:413-305-1867
Practice Address - Street 1:1 LONG WHARF DR STE 303
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5944
Practice Address - Country:US
Practice Address - Phone:860-270-0755
Practice Address - Fax:413-305-1867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty