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General NPI Number Information
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NPI Number | 1417556317
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND ADVANCED SPINE & PAIN CENTER LLC
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 115 TECHNOLOGY DR STE B202
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City | TRUMBULL
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State | CT
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Zip | 06611-6337
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Country | US
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Telephone | 203-548-7590
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Fax | 855-950-0826
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Provider Business Mailing Address
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Address Line | 7 RED MILL LN
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City | DARIEN
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State | CT
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Zip | 06820-3612
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Country | US
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Telephone | 203-548-7590
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Fax | 855-950-0826
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Authorized Official
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Title or Position | OWNER
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Name | DR. BASSEM O ABRAHAM
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Credential | MD
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Telephone | 203-548-7590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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