Healthcare Provider Details

I. General information

NPI: 1205077542
Provider Name (Legal Business Name): BRIGHTER CONCEPT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 POST RD SUITE # LL 105
FAIRFIELD CT
06824-5730
US

IV. Provider business mailing address

2000 POST RD SUITE # LL 105
FAIRFIELD CT
06824-5730
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-8068
  • Fax: 203-547-7177
Mailing address:
  • Phone: 203-292-8068
  • Fax: 203-547-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number043546
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number043546
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number043546
License Number StateCT

VIII. Authorized Official

Name: ASHIWNI SABNIS
Title or Position: M.D
Credential: M.D
Phone: 203-292-8068