Healthcare Provider Details

I. General information

NPI: 1841870375
Provider Name (Legal Business Name): WELLNESS VIA NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 BREAKWATER LN
WINDSOR CT
06095-3299
US

IV. Provider business mailing address

8 BREAKWATER LN
WINDSOR CT
06095-3299
US

V. Phone/Fax

Practice location:
  • Phone: 860-634-1511
  • Fax:
Mailing address:
  • Phone: 860-634-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: SARAH FARID-CHAUDHRY
Title or Position: CLINICAL NUTRITIONIST, OWNER
Credential: MS, CNS
Phone: 860-634-1511