Provider Demographics
NPI:1497291991
Name:INTEGRITY NATURAL MEDICINE LLC
Entity Type:Organization
Organization Name:INTEGRITY NATURAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:860-980-1221
Mailing Address - Street 1:24 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1102
Mailing Address - Country:US
Mailing Address - Phone:860-980-1221
Mailing Address - Fax:
Practice Address - Street 1:1057 POQUONNOCK RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6630
Practice Address - Country:US
Practice Address - Phone:860-980-1221
Practice Address - Fax:860-415-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT582175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty