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General NPI Number Information
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NPI Number | 1467672592
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PAIN AND HEADACHE TREATMENT CENTERS, LLC
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 130 DIVISION STREET
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City | DERBY
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State | CT
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Zip | 06418
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Country | US
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Telephone | 203-732-1570
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Fax | 203-732-1576
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Provider Business Mailing Address
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Address Line | 130 DIVISION STREET
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City | DERBY
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State | CT
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Zip | 06418
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Country | US
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Telephone | 203-732-1570
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Fax | 203-732-1576
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Authorized Official
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Title or Position | BILLING LEAD
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Name | MRS. DEBORAH LECHNER
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Credential |
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Telephone | 203-732-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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