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General NPI Number Information
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NPI Number | 1831483221
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Entity Type | Organization
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Legal Business Name | CONNECTICUT INTEGRATED NATUROPATHICS LLC
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 06/03/2011
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Provider Practice Location Address
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Address Line | 590 MIDDLEBURY RD STE B
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City | MIDDLEBURY
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State | CT
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Zip | 06762-2563
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Country | US
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Telephone | 203-577-2095
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Fax |
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Provider Business Mailing Address
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Address Line | 24B HAPPY HOLLOW CIR
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City | STRATFORD
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State | CT
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Zip | 06614-8439
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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 | MEMBER
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Name | DR. SHARMILEE JAYACHANDRAN
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Credential | ND
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Telephone | 203-551-1160
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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 | 000455
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License Number State | CT
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