Healthcare Provider Details

I. General information

NPI: 1699893958
Provider Name (Legal Business Name): BARBARA F RASSOW DC CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 12/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MAIN ST SUITE 204
WESTPORT CT
06880-3216
US

IV. Provider business mailing address

225 MAIN ST SUITE 204
WESTPORT CT
06880-3216
US

V. Phone/Fax

Practice location:
  • Phone: 203-226-7722
  • Fax:
Mailing address:
  • Phone: 203-226-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number000454
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number000304
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001279-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: