Healthcare Provider Details

I. General information

NPI: 1922628957
Provider Name (Legal Business Name): PAIN MANAGEMENT PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 MOUNT PLEASANT RD STE 200
NEWTOWN CT
06470-1474
US

IV. Provider business mailing address

7 OLD SHERMAN TPKE STE 209
DANBURY CT
06810-4174
US

V. Phone/Fax

Practice location:
  • Phone: 203-885-1441
  • Fax: 203-628-7350
Mailing address:
  • Phone: 203-885-1441
  • Fax: 475-329-2283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ANN SPRAGUE
Title or Position: PRACTICE MANAGER
Credential: DO
Phone: 203-885-1441