Healthcare Provider Details

I. General information

NPI: 1235051178
Provider Name (Legal Business Name): REALM HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PINE GROVE RD
BLOOMFIELD CT
06002-3326
US

IV. Provider business mailing address

10 PINE GROVE RD
BLOOMFIELD CT
06002-3326
US

V. Phone/Fax

Practice location:
  • Phone: 475-559-9192
  • Fax:
Mailing address:
  • Phone: 475-559-9192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NYKESIA LYTTLE
Title or Position: MANAGER
Credential:
Phone: 475-559-9192