Provider Demographics
NPI:1831483221
Name:CONNECTICUT INTEGRATED NATUROPATHICS LLC
Entity Type:Organization
Organization Name:CONNECTICUT INTEGRATED NATUROPATHICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARMILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYACHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-551-1160
Mailing Address - Street 1:24B HAPPY HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:590 MIDDLEBURY RD STE B
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2563
Practice Address - Country:US
Practice Address - Phone:203-577-2095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000455175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty