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General NPI Number Information
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NPI Number | 1205647997
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR HEADACHE AND BRAIN HEALTH
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 90 MORGAN STREET SUITE 305-306
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City | STAMFORD
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State | CT
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Zip | 06905
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Country | US
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Telephone | 203-306-2949
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Fax | 203-884-8939
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Provider Business Mailing Address
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Address Line | 90 MORGAN STREET SUITE 305-306
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City | STAMFORD
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State | CT
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Zip | 06905
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Country | US
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Telephone | 203-306-2949
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Fax | 203-884-8939
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Authorized Official
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Title or Position | FOUNDER, MEDICAL DIRECTOR, NEUROLOG
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Name | DR. OLIVIA ANNA JEAN BEGASSE DE DHAEM
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Credential | MD.
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Telephone | 203-306-2949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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