Provider Demographics
NPI:1700122744
Name:STAMFORD CENTER FOR NATURAL HEALTH
Entity Type:Organization
Organization Name:STAMFORD CENTER FOR NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FUTTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-325-3535
Mailing Address - Street 1:111 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3813
Mailing Address - Country:US
Mailing Address - Phone:203-325-3535
Mailing Address - Fax:203-504-5020
Practice Address - Street 1:111 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3813
Practice Address - Country:US
Practice Address - Phone:203-325-3535
Practice Address - Fax:203-504-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000394175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty