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General NPI Number Information
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NPI Number | 1366379042
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE PAIN CARE & WELLNESS CENTER OF CONNECTICUT
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 2 TRAP FALLS RD STE 510
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City | SHELTON
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State | CT
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Zip | 06484-7622
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Country | US
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Telephone | 203-395-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 72 COTTAGE ST
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City | MONROE
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State | CT
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Zip | 06468-2917
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | JODY KUSHEBA
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Credential | APRN, FNP-BC
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Telephone | 203-395-4867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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