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General NPI Number Information
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NPI Number | 1255745741
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PAIN CLINIC PC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 677 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3158
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Country | US
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Telephone | 203-699-8880
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Fax | 203-271-1841
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Provider Business Mailing Address
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Address Line | 677 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3158
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Country | US
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Telephone | 203-699-8880
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Fax | 203-271-1841
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Authorized Official
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Title or Position | OWNER
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Name | DR. YASSAR F SHAHEEN
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Credential | MD
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Telephone | 401-723-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 42472
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License Number State | CT
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