Provider Demographics
NPI:1083785851
Name:DE KADT, SHARON DRU (NATUROPATHIC PHYSICI)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DRU
Last Name:DE KADT
Suffix:
Gender:F
Credentials:NATUROPATHIC PHYSICI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 AMITY RD
Mailing Address - Street 2:245 AMITY RD, SUITE 204
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525
Mailing Address - Country:US
Mailing Address - Phone:203-624-4044
Mailing Address - Fax:
Practice Address - Street 1:245 AMITY RD
Practice Address - Street 2:245 AMITY RD, SUITE 204
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525
Practice Address - Country:US
Practice Address - Phone:203-624-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000500363A00000X
CT000092175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant