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General NPI Number Information
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NPI Number | 1447509427
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALTHY LIVING
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 30 BRIDGE ST UNIT 103
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City | NEW MILFORD
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State | CT
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Zip | 06776-3517
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Country | US
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Telephone | 914-245-3056
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Fax |
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Provider Business Mailing Address
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Address Line | 30 BRIDGE ST UNIT 103
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City | NEW MILFORD
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State | CT
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Zip | 06776-3517
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Country | US
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Telephone | 914-245-3056
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROL HARRACKSINGH
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Credential | M.D.
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Telephone | 914-245-3056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1845441
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License Number State | NY
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