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General NPI Number Information
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NPI Number | 1790476919
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Entity Type | Organization
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Legal Business Name | VITALITY WEIGHT AND HORMONE SOLUTIONS LLC
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 203 BROAD STREET SUITE C3
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City | MILFORD
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State | CT
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Zip | 06460
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Country | US
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Telephone | 203-871-1953
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Fax | 475-275-7232
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Provider Business Mailing Address
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Address Line | 1371 BOSTON POST ROAD, #1061
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City | MILFORD
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State | CT
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Zip | 06460
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Country | US
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Telephone | 203-871-1953
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | LESLEY NICOLE CHARLES
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Credential | APRN
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Telephone | 203-871-1953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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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 | 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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