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General NPI Number Information
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NPI Number | 1245560317
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Entity Type | Organization
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Legal Business Name | NATUROPATHIC FAMILY MEDICINE AND NUTRITION CENTER, LLC
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2 CORPORATE DR STE 206
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City | TRUMBULL
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State | CT
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Zip | 06611-1376
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Country | US
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Telephone | 203-371-1021
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CORPORATE DR STE 206
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City | TRUMBULL
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State | CT
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Zip | 06611-1376
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Country | US
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Telephone | 203-371-1021
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Fax | 203-371-1022
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Authorized Official
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Title or Position | OWNER
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Name | DR. NATALIE COLICCI-FAVRETTO
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Credential | ND
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Telephone | 203-371-1021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 000843
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License Number State | CT
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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 | 000420
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License Number State | CT
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