Provider Demographics
NPI:1295205797
Name:NELSON, GIOVANNI ANTHONY (ND)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:ANTHONY
Last Name:NELSON
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 1:9 MOTT AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3359
Mailing Address - Country:US
Mailing Address - Phone:203-693-1429
Mailing Address - Fax:203-405-0068
Practice Address - Street 1:9 MOTT AVE STE 203
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3359
Practice Address - Country:US
Practice Address - Phone:203-693-1429
Practice Address - Fax:203-405-0068
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT638175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath