Provider Demographics
NPI:1831647957
Name:STRAUN HEALTH & WELLNESS
Entity Type:Organization
Organization Name:STRAUN HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TEO-CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-756-0455
Mailing Address - Street 1:1224 MILL ST
Mailing Address - Street 2:BLDG B
Mailing Address - City:EAST BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06023-1159
Mailing Address - Country:US
Mailing Address - Phone:860-756-0455
Mailing Address - Fax:866-469-7058
Practice Address - Street 1:1224 MILL ST
Practice Address - Street 2:BLDG B
Practice Address - City:EAST BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06023-1159
Practice Address - Country:US
Practice Address - Phone:860-756-0455
Practice Address - Fax:866-469-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-18
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0508442084P0800X, 2084P0802X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty