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NPI Code Detail

MEDICARE: NEW HAVNE NATUROPATHIC CENTER

MEDICARE: NEW HAVNE NATUROPATHIC CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center#000301CT
2175F00000XNaturopath#000301CT

General Provider Information

NPI Number : 1811221955
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW HAVNE NATUROPATHIC CENTER
Provider Business Mailing Address
First Line : 1079 WHALLEY AVE
Second Line : SUITE 4
City : NEW HAVEN
State : CT
Zip : 06515-1783
Country : US
Telephone Number : 203-387-5015
Fax Number : 203-387-3500
Provider Business Practice Location Address
First Line : 1079 WHALLEY AVE
Second Line : SUITE 4
City : NEW HAVEN
State : CT
Zip : 06515-1783
Country : US
Telephone Number : 203-387-5015
Fax Number : 203-387-3500
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : DR. JENNIFER DOROTHY BOTWICK
Credential : N.D.
Telephone Number : 203-387-5015
Provider Enumeration Date : 09/22/2009
Last Update Date : 09/22/2009

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Directions to “NEW HAVNE NATUROPATHIC CENTER ” Practice Location

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