Healthcare Provider Details

I. General information

NPI: 1821617143
Provider Name (Legal Business Name): WHOLE HEALTH NATURAL FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 04/16/2020
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2838 OLD DIXWELL AVE
HAMDEN CT
06518-3137
US

IV. Provider business mailing address

2838 OLD DIXWELL AVE
HAMDEN CT
06518-3137
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-8283
  • Fax: 203-288-8405
Mailing address:
  • Phone: 203-288-8283
  • Fax: 203-288-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALLISON MARIE FORGETTE
Title or Position: OFFICE MANAGER
Credential:
Phone: 203-288-8283