Provider Demographics
NPI:1740334275
Name:AMICONE, CHRISTINA (ND)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:AMICONE
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 1:395 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:CT
Mailing Address - Zip Code:06756-2309
Mailing Address - Country:US
Mailing Address - Phone:860-480-1079
Mailing Address - Fax:
Practice Address - Street 1:63 WEST ST STE B1
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3558
Practice Address - Country:US
Practice Address - Phone:860-361-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT101175F00000X
CT000433175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath