Healthcare Provider Details

I. General information

NPI: 1629597836
Provider Name (Legal Business Name): MARIE CHRISTINE WINTERS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 LAFAYETTE ST
BRIDGEPORT CT
06604-7719
US

IV. Provider business mailing address

737 DUDLEY ST
PHILADELPHIA PA
19148-2423
US

V. Phone/Fax

Practice location:
  • Phone: 203-576-4126
  • Fax:
Mailing address:
  • Phone: 215-313-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number607
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: