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General NPI Number Information
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NPI Number | 1942866793
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Entity Type | Organization
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Legal Business Name | LIVWELL PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 764 CAMPBELL AVE STE F
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City | WEST HAVEN
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State | CT
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Zip | 06516-3786
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Country | US
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Telephone | 203-443-9500
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Fax | 203-902-0509
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Provider Business Mailing Address
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Address Line | 764 CAMPBELL AVE STE F
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City | WEST HAVEN
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State | CT
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Zip | 06516-3786
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Country | US
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Telephone | 203-439-5000
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | DR. KRIPA PLAPETTA DAMODHARAN
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Credential | DNP, FNP -BC
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Telephone | 203-443-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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