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General NPI Number Information
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NPI Number | 1437708708
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Entity Type | Organization
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Legal Business Name | CLEAN RXEACH LLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 1506 POST RD STE 4
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City | FAIRFIELD
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State | CT
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Zip | 06824-5916
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Country | US
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Telephone | 203-292-0764
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Fax | 214-440-1671
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Provider Business Mailing Address
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Address Line | 340 PRAYER SPRING RD
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City | STRATFORD
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State | CT
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Zip | 06614-1322
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Country | US
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Telephone | 214-991-6411
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Fax | 214-440-1671
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Authorized Official
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Title or Position | OWNER
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Name | AIKATERINI FINETI
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Credential |
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Telephone | 203-292-0764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health 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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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