Provider Demographics
NPI:1942713722
Name:EMERALD CITY HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:EMERALD CITY HEALTH ASSOCIATES
Other - Org Name:EMERALD CITY HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-693-1932
Mailing Address - Street 1:650 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2029
Mailing Address - Country:US
Mailing Address - Phone:203-970-9771
Mailing Address - Fax:
Practice Address - Street 1:650 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2029
Practice Address - Country:US
Practice Address - Phone:508-221-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT602175F00000X
MDJ0000033175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty