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General NPI Number Information
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NPI Number | 1003591801
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Entity Type | Organization
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Legal Business Name | INSPIRATION PSYCHIATRY PLLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 66 CEDAR ST STE 204
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City | NEWINGTON
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State | CT
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Zip | 06111-2655
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Country | US
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Telephone | 866-333-9758
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Fax | 866-299-1960
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Provider Business Mailing Address
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Address Line | 66 CEDAR ST STE 204
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City | NEWINGTON
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State | CT
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Zip | 06111-2655
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Country | US
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Telephone | 866-333-9758
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Fax | 866-299-1960
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Authorized Official
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Title or Position | OWNER
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Name | JEONG MI PAK
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Credential |
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Telephone | 702-721-3541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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