Healthcare Provider Details

I. General information

NPI: 1255267043
Provider Name (Legal Business Name): PAIN RX CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CRESTVIEW DR
WESTERLY RI
02891-2907
US

IV. Provider business mailing address

287 W SPRING ST
WEST HAVEN CT
06516-3354
US

V. Phone/Fax

Practice location:
  • Phone: 203-295-7855
  • Fax:
Mailing address:
  • Phone: 203-295-7855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRIPA PLAPETTA DAMODHARAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: DNP, FNP
Phone: 203-285-5900