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General NPI Number Information
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NPI Number | 1033855648
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Entity Type | Organization
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Legal Business Name | SUNRISE INTEGRATIVE HEALTH PLLC
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 2389 MAIN ST STE 100
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone | 860-370-4186
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Fax | 203-643-2313
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Provider Business Mailing Address
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Address Line | 1201 KINGS HWY STE 2
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City | FAIRFIELD
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State | CT
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Zip | 06824-5319
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Country | US
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Telephone | 860-370-4186
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Fax | 203-643-2313
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANAICA QUAO
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Credential | DNP, APRN
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Telephone | 860-370-4186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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