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General NPI Number Information
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NPI Number | 1972556165
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Entity Type | Organization
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Legal Business Name | HARTFORD HEADACHE CENTER, LLC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 144 MAIN STREET SUITE D
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City | EAST HARTFORD
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State | CT
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Zip | 06118
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Country | US
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Telephone | 860-895-3133
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Fax | 860-895-3131
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Provider Business Mailing Address
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Address Line | 144 MAIN STREET SUITE D
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City | EAST HARTFORD
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State | CT
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Zip | 06118
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Country | US
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Telephone | 860-895-3133
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Fax | 860-895-3131
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Authorized Official
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Title or Position | DIRECTOR HARTFORD HEADACHE CENTER
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Name | DR. TANYA R BILCHIK
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Credential | MD
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Telephone | 860-895-3133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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