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General NPI Number Information
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NPI Number | 1134575509
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Entity Type | Organization
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Legal Business Name | COREBELLA HEALTH LLC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 417 HIGHLAND AVE STE 2
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City | WATERBURY
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State | CT
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Zip | 06708-3454
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Country | US
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Telephone | 203-757-9336
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Fax | 888-532-1877
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Provider Business Mailing Address
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Address Line | 417 HIGHLAND AVE STE 2
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City | WATERBURY
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State | CT
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Zip | 06708-3454
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Country | US
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Telephone | 203-757-9336
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Fax | 888-532-1877
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Authorized Official
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Title or Position | OWNER
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Name | MARCOS MALLI DE ESCOBAR
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Credential |
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Telephone | 203-757-9336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 6917
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License Number State | CT
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