Provider Demographics
NPI:1205647997
Name:INSTITUTE FOR HEADACHE AND BRAIN HEALTH
Entity type:Organization
Organization Name:INSTITUTE FOR HEADACHE AND BRAIN HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:ANNA JEAN
Authorized Official - Last Name:BEGASSE DE DHAEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-214-9946
Mailing Address - Street 1:1275 SUMMER STREET SUITE 306
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5315
Mailing Address - Country:US
Mailing Address - Phone:203-306-2949
Mailing Address - Fax:203-884-8939
Practice Address - Street 1:1275 SUMMER STREET SUITE 306
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5315
Practice Address - Country:US
Practice Address - Phone:203-306-2949
Practice Address - Fax:203-884-8939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty