Provider Demographics
NPI:1679215008
Name:INNER HEALTH & HEALING OF NY AND CT
Entity Type:Organization
Organization Name:INNER HEALTH & HEALING OF NY AND CT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCHIAROLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-444-6204
Mailing Address - Street 1:109 DANBURY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 DANBURY RD STE 4
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4109
Practice Address - Country:US
Practice Address - Phone:475-444-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health