Healthcare Provider Details

I. General information

NPI: 1659822369
Provider Name (Legal Business Name): SARA FRAWLEY N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N. MAIN STREET EXTENTION BUILDING 2 SUITE 3C
WALLINGFORD CT
06492
US

IV. Provider business mailing address

523 BALDWIN AVE
MERIDEN CT
06450-3546
US

V. Phone/Fax

Practice location:
  • Phone: 203-284-1119
  • Fax:
Mailing address:
  • Phone: 203-293-0212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number574
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: