Healthcare Provider Details

I. General information

NPI: 1770447542
Provider Name (Legal Business Name): PAIN MANAGEMENT ASSOCIATES OF CONNECTICUT, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HIGH RIDGE RD 3RD FLOOR
STAMFORD CT
06905-1202
US

IV. Provider business mailing address

1200 HIGH RIDGE RD 3RD FLOOR
STAMFORD CT
06905-1202
US

V. Phone/Fax

Practice location:
  • Phone: 203-487-2353
  • Fax: 800-700-6986
Mailing address:
  • Phone: 203-487-2353
  • Fax: 800-700-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VINCENT R CARLESI
Title or Position: CEO
Credential:
Phone: 203-325-5700