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NPI 1386041788

NPI 1386041788 : ELISE PANZA N.D. : CHESHIRE, CT

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General NPI Number Information
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    NPI Number           |    1386041788
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    Entity Type          |    Individual 
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    Provider Name        |    ELISE PANZA N.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/01/2014
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    Last Update Date     |    12/01/2014
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Provider Practice Location Address
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    Address Line         |    288 HIGHLAND AVE NEW ENGLAND NATUROPATHIC CENTER
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    City                 |    CHESHIRE
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    State                |    CT
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    Zip                  |    06410-2540
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    Country              |    US
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    Telephone            |    203-271-1311
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    288 HIGHLAND AVE NEW ENGLAND NATUROPATHIC CENTER
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    City                 |    CHESHIRE
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    State                |    CT
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    Zip                  |    06410-2540
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    Country              |    US
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    Telephone            |    203-271-1311
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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        |    175F00000X
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    Taxonomy Name        |    Naturopath
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    License Number       |    529
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    License Number State |    CT
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