Provider Demographics
NPI:1821412511
Name:ZEN HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ZEN HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-437-8468
Mailing Address - Street 1:506 FROST RD
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-2304
Mailing Address - Country:US
Mailing Address - Phone:203-437-8368
Mailing Address - Fax:203-805-4316
Practice Address - Street 1:636 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4447
Practice Address - Country:US
Practice Address - Phone:203-298-4600
Practice Address - Fax:203-805-4316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty