Provider Demographics
NPI:1346502895
Name:JENNIFER HOLDORF NATUROPATHIC, LLC
Entity Type:Organization
Organization Name:JENNIFER HOLDORF NATUROPATHIC, LLC
Other - Org Name:NEW START NATUROPATHIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDORF
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-415-1476
Mailing Address - Street 1:145 CANAL ST
Mailing Address - Street 2:UNIT 307
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-8100
Mailing Address - Country:US
Mailing Address - Phone:203-415-1476
Mailing Address - Fax:
Practice Address - Street 1:555 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4749
Practice Address - Country:US
Practice Address - Phone:203-415-1476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000450175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty