Provider Demographics
NPI:1437985629
Name:THE BRAIN BRIDGE PLLC
Entity type:Organization
Organization Name:THE BRAIN BRIDGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-513-9456
Mailing Address - Street 1:4 RESEARCH DR STE 402
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6242
Mailing Address - Country:US
Mailing Address - Phone:203-513-9456
Mailing Address - Fax:
Practice Address - Street 1:4 RESEARCH DR STE 402
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6242
Practice Address - Country:US
Practice Address - Phone:203-513-9456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2025-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)