Provider Demographics
NPI:1962806679
Name:NEW SOLUTIONS PAIN MANAGEMENT CLINIC LLC
Entity type:Organization
Organization Name:NEW SOLUTIONS PAIN MANAGEMENT CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TESTO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:475-882-6824
Mailing Address - Street 1:236 BOSTON POST ROAD
Mailing Address - Street 2:UNIT 1A
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3690
Mailing Address - Country:US
Mailing Address - Phone:475-882-6824
Mailing Address - Fax:203-693-2320
Practice Address - Street 1:236 BOSTON POST ROAD
Practice Address - Street 2:UNIT 1A
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3690
Practice Address - Country:US
Practice Address - Phone:475-882-6824
Practice Address - Fax:203-693-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2024-10-21
Deactivation Date:2023-08-08
Deactivation Code:
Reactivation Date:2023-08-21
Provider Licenses
StateLicense IDTaxonomies
CT004689363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty