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General NPI Number Information
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NPI Number | 1053825323
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Entity Type | Individual
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Provider Name | THOMAS SAID FAULWELL
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Gender | Male
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Dates
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Enumeration Date | 11/25/2017
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Last Update Date | 11/25/2017
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Provider Practice Location Address
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Address Line | 59 ELM ST STE 100
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City | NEW HAVEN
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State | CT
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Zip | 06510-2047
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Country | US
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Telephone | 805-404-0361
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Fax |
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Provider Business Mailing Address
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Address Line | 434 GEORGE ST APT 3
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City | NEW HAVEN
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State | CT
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Zip | 06511-5489
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Country | US
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Telephone | 805-404-0361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 714
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License Number State | CT
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