Healthcare Provider Details

I. General information

NPI: 1841775210
Provider Name (Legal Business Name): HEALING DUO INTEGRATIVE FAMILY MEDICAL PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 09/27/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 MOTT AVE STE 203
NORWALK CT
06850-3359
US

IV. Provider business mailing address

9 MOTT AVE STE 203
NORWALK CT
06850-3359
US

V. Phone/Fax

Practice location:
  • Phone: 203-693-1429
  • Fax: 203-405-0068
Mailing address:
  • Phone: 203-693-1429
  • Fax: 203-405-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GIOVANNI ANTHONY NELSON
Title or Position: CHIEF MEDICAL OFFICER
Credential: ND
Phone: 914-217-4065