Provider Demographics
NPI:1790416949
Name:AVEO LLC
Entity Type:Organization
Organization Name:AVEO LLC
Other - Org Name:AVEO FUNCTIONAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHYENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARNESE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:959-901-5583
Mailing Address - Street 1:59 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4955
Mailing Address - Country:US
Mailing Address - Phone:860-921-7504
Mailing Address - Fax:860-393-1082
Practice Address - Street 1:59 FIELD ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4955
Practice Address - Country:US
Practice Address - Phone:860-921-7504
Practice Address - Fax:860-393-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty