Provider Demographics
NPI:1265845333
Name:NATURAE MEDICAL
Entity Type:Organization
Organization Name:NATURAE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVIVA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WERTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:802-251-7476
Mailing Address - Street 1:20 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9181
Mailing Address - Country:US
Mailing Address - Phone:802-251-7476
Mailing Address - Fax:
Practice Address - Street 1:20 TECHNOLOGY DR
Practice Address - Street 2:SUITE 7
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-9181
Practice Address - Country:US
Practice Address - Phone:802-251-7476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0100226175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty