| Joint Pain Treatment Center, Llc | |
|
417 Highland Ave Waterbury CT 06708-3454 | |
| (203) 504-7518 | |
| Not Available |
| Full Name | Joint Pain Treatment Center, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 417 Highland Ave, Waterbury, Connecticut |
| Authorized Official Name and Position | Kristen Donohue (OWNER, NP DIRECTOR) |
| Authorized Official Contact | 2038956572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joint Pain Treatment Center, Llc 417 Highland Ave Waterbury CT 06708-3454 Ph: (203) 504-7518 | Joint Pain Treatment Center, Llc 417 Highland Ave Waterbury CT 06708-3454 Ph: (203) 504-7518 |
| NPI Number | 1760172001 |
|---|---|
| Provider Enumeration Date | 05/10/2023 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 7315304060 |
|---|---|
| Medicare Enrollment ID | O20230612001284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760172001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Kristen F Donohue-gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184999468 PECOS PAC ID: 3274850102 Enrollment ID: I20170911002325 |
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