Provider Demographics
NPI:1760738637
Name:LABAREDAS, NELSON G (ND, DIPL AC)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:G
Last Name:LABAREDAS
Suffix:
Gender:M
Credentials:ND, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 BOOTH HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2401
Mailing Address - Country:US
Mailing Address - Phone:203-954-9475
Mailing Address - Fax:
Practice Address - Street 1:245 BOOTH HILL RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-2401
Practice Address - Country:US
Practice Address - Phone:203-954-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT563171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist