Healthcare Provider Details

I. General information

NPI: 1396677977
Provider Name (Legal Business Name): GRACEPOINT HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 BOOTH HILL RD
TRUMBULL CT
06611-4009
US

IV. Provider business mailing address

634 BOOTH HILL RD
TRUMBULL CT
06611-4009
US

V. Phone/Fax

Practice location:
  • Phone: 860-849-8913
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DELORES BANI
Title or Position: OWNER
Credential: MD
Phone: 860-849-8913