Provider Demographics
NPI:1295504892
Name:HOLISTIC MEDICAL CARE LLC
Entity type:Organization
Organization Name:HOLISTIC MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKODIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-596-0705
Mailing Address - Street 1:320 BOSTON POST RD STE 180 1021
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:086-259-6070
Mailing Address - Fax:
Practice Address - Street 1:320 BOSTON POST RD STE 180 1021
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3600
Practice Address - Country:US
Practice Address - Phone:862-596-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty