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General NPI Number Information
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NPI Number | 1558720854
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Entity Type | Organization
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Legal Business Name | BODHI NATUROPATHIC LLC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 17 HOPE STREET
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City | NIANIC
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State | CT
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Zip | 06357
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Country | US
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Telephone | 860-451-9650
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Fax | 888-978-7316
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Provider Business Mailing Address
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Address Line | 17 HOPE STREET
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City | NIANIC
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State | CT
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Zip | 06357
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Country | US
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Telephone | 860-451-9650
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Fax | 888-978-7316
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Authorized Official
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Title or Position | OWNER, OPERATOR, PROVIDER
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Name | DR. SARAH MARIE ZAMBARANO
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Credential | FNP-C, APRN, ND
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Telephone | 860-451-9650
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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 | 000477
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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