Healthcare Provider Details

I. General information

NPI: 1225824535
Provider Name (Legal Business Name): MICHAEL MARTINS PINHEIRO PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 MIST HILL DR
BROOKFIELD CT
06804-1611
US

IV. Provider business mailing address

80 WEST ST
DANBURY CT
06810-6531
US

V. Phone/Fax

Practice location:
  • Phone: 203-470-6885
  • Fax:
Mailing address:
  • Phone: 203-748-5689
  • Fax: 203-791-2374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14699
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: