Provider Demographics
NPI:1558720854
Name:BODHI NATUROPATHIC LLC
Entity Type:Organization
Organization Name:BODHI NATUROPATHIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR, PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZAMBARANO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, APRN, ND
Authorized Official - Phone:860-451-9650
Mailing Address - Street 1:17 HOPE STREET
Mailing Address - Street 2:
Mailing Address - City:NIANIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357
Mailing Address - Country:US
Mailing Address - Phone:860-451-9650
Mailing Address - Fax:888-978-7316
Practice Address - Street 1:17 HOPE STREET
Practice Address - Street 2:
Practice Address - City:NIANIC
Practice Address - State:CT
Practice Address - Zip Code:06357
Practice Address - Country:US
Practice Address - Phone:860-451-9650
Practice Address - Fax:888-978-7316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000477175F00000X
175F00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty