=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639295504
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. MICHAEL ARMENTANO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 296 SOUND BEACH AVE
-----------------------------------------------------
City | OLD GREENWICH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06870-1626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-637-8464
-----------------------------------------------------
Fax | 203-413-6303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31 BRINSMADE LN
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06784-1434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-637-8464
-----------------------------------------------------
Fax | 203-413-6303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | 000287
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------