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General NPI Number Information
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NPI Number | 1811191216
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Entity Type | Organization
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Legal Business Name | EASTERN CONNECTICUT PAIN TREATMENT CENTER LLC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 190 W TOWN ST
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City | NORWICH
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State | CT
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Zip | 06360-2131
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Country | US
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Telephone | 860-885-0333
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Fax | 860-885-1319
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Provider Business Mailing Address
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Address Line | 190 W TOWN ST
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City | NORWICH
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State | CT
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Zip | 06360-2131
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Country | US
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Telephone | 860-885-0333
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Fax | 860-885-1319
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Authorized Official
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Title or Position | MD
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Name | DR. JOHN J PAGGIOLI
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Credential | MD
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Telephone | 860-885-0333
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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 | 035017
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License Number State | CT
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