Provider Demographics
NPI:1972563146
Name:RZUCIDLO, SUSAN (ND)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:RZUCIDLO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SHEPHERD ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2408
Mailing Address - Country:US
Mailing Address - Phone:203-229-9712
Mailing Address - Fax:
Practice Address - Street 1:80 FERRY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6079
Practice Address - Country:US
Practice Address - Phone:203-377-1525
Practice Address - Fax:203-380-2831
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000261175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath