Provider Demographics
NPI:1124226956
Name:SERES, RICHARD ALBERT (ND)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALBERT
Last Name:SERES
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5916
Mailing Address - Country:US
Mailing Address - Phone:203-256-9992
Mailing Address - Fax:
Practice Address - Street 1:1506 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5916
Practice Address - Country:US
Practice Address - Phone:203-256-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000322175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000322OtherLICENSE NUMBER