Provider Demographics
NPI:1841775210
Name:HEALING DUO INTEGRATIVE FAMILY MEDICAL PRACTICE LLC
Entity Type:Organization
Organization Name:HEALING DUO INTEGRATIVE FAMILY MEDICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:914-217-4065
Mailing Address - Street 1:9 MOTT AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3359
Mailing Address - Country:US
Mailing Address - Phone:203-693-1429
Mailing Address - Fax:203-405-0068
Practice Address - Street 1:9 MOTT AVE STE 203
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3359
Practice Address - Country:US
Practice Address - Phone:203-693-1429
Practice Address - Fax:203-405-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty