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General NPI Number Information
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NPI Number | 1750234605
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Entity Type | Organization
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Legal Business Name | LIFESTYLE RX WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 7 SHANNON RIDGE ROAD
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City | DANBURY
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State | CT
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Zip | 06810
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Country | US
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Telephone | 203-770-5698
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Fax |
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Provider Business Mailing Address
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Address Line | 461 MONROE TPKE # 1007
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City | MONROE
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State | CT
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Zip | 06468-2338
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER & FNP
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Name | ANWAR ESAM ABDULREHMAN
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Credential | MSN, APRN, FNP-C
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Telephone | 203-770-5698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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