Healthcare Provider Details

I. General information

NPI: 1275459661
Provider Name (Legal Business Name): RADIANT WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2447 WHITNEY AVE STE 103
HAMDEN CT
06518-3211
US

IV. Provider business mailing address

2447 WHITNEY AVE STE 103
HAMDEN CT
06518-3211
US

V. Phone/Fax

Practice location:
  • Phone: 203-804-1978
  • Fax: 475-219-6512
Mailing address:
  • Phone: 203-804-1978
  • Fax: 475-219-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NEZHA ELOMARI
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 203-804-1978