Healthcare Provider Details

I. General information

NPI: 1710625959
Provider Name (Legal Business Name): COMPREHENSIVE NEUROLOGY AND PAIN CENTER OF CONNECTICUT STAMFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 GROVE ST
RIDGEFIELD CT
06877-4131
US

IV. Provider business mailing address

66 GROVE ST
RIDGEFIELD CT
06877-4131
US

V. Phone/Fax

Practice location:
  • Phone: 203-626-9080
  • Fax:
Mailing address:
  • Phone: 203-626-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IGOR GENE TUROK
Title or Position: OWNER
Credential: MD
Phone: 203-626-9080