| Total Pain Treatment Centers Of Ct | |
|
136 Sherman Avenue Lower Level New Haven CT 06511-5238 | |
| (203) 565-5104 | |
| (860) 826-4762 |
| Full Name | Total Pain Treatment Centers Of Ct |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 136 Sherman Avenue, New Haven, Connecticut |
| Authorized Official Name and Position | Eric Voide (MANAGER) |
| Authorized Official Contact | 2035655104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Pain Treatment Centers Of Ct 34 Cedarland Court Cromwell CT 06416-1750 Ph: (203) 565-5104 | Total Pain Treatment Centers Of Ct 136 Sherman Avenue Lower Level New Haven CT 06511-5238 Ph: (203) 565-5104 |
| NPI Number | 1265144935 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 8921479502 |
|---|---|
| Medicare Enrollment ID | O20230118001007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265144935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Ann Marie Julian |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336156876 PECOS PAC ID: 8022097138 Enrollment ID: I20040714000276 |
| Provider Name | Mary M Colburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679066948 PECOS PAC ID: 5597018606 Enrollment ID: I20181018002720 |
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