Healthcare Provider Details
I. General information
NPI: 1649105289
Provider Name (Legal Business Name): CONNECTICUT HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33 RUGBY RD
SHELTON CT
06484-1683
US
IV. Provider business mailing address
33 RUGBY RD
SHELTON CT
06484-1683
US
V. Phone/Fax
- Phone: 203-516-7160
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRYAN
FIX
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 203-516-7160