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General NPI Number Information
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NPI Number | 1336300144
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Entity Type | Organization
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Legal Business Name | REALITY LLC
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 10 ROCKY RIDGE DR
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City | TRUMBULL
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State | CT
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Zip | 06611-5339
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Country | US
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Telephone | 203-556-0790
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Fax | 203-502-8064
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Provider Business Mailing Address
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Address Line | PO BOX 764
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City | STRATFORD
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State | CT
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Zip | 06615-0764
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Country | US
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Telephone | 203-556-0790
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Fax | 203-502-8064
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ALEXANDER VINCENT COLONDONA
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Credential | DC
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Telephone | 203-556-0790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 824
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License Number State | CT
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