Healthcare Provider Details

I. General information

NPI: 1407260516
Provider Name (Legal Business Name): NEW DIRECTIONS IN MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 MAIN ST SUITE 1
SALISBURY CT
06068-1804
US

IV. Provider business mailing address

199 MAIN ST SUITE 1
SALISBURY CT
06068-1804
US

V. Phone/Fax

Practice location:
  • Phone: 860-435-3009
  • Fax: 860-831-0309
Mailing address:
  • Phone: 860-435-3009
  • Fax: 860-831-0309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number000348
License Number StateCT

VIII. Authorized Official

Name: DR. RICHARD MALIK
Title or Position: PRESIDENT
Credential: ND
Phone: 860-435-3009