Provider Demographics
NPI:1780456319
Name:GREENWICH PAIN AND SPINE
Entity type:Organization
Organization Name:GREENWICH PAIN AND SPINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-204-5383
Mailing Address - Street 1:500 W PUTNAM AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6079
Mailing Address - Country:US
Mailing Address - Phone:973-204-5383
Mailing Address - Fax:
Practice Address - Street 1:500 W PUTNAM AVE STE 440
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6079
Practice Address - Country:US
Practice Address - Phone:973-204-5383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty