Provider Demographics
NPI:1386314888
Name:WOMEN FAMILY HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:WOMEN FAMILY HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SURSATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHETRAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-500-6152
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-0211
Mailing Address - Country:US
Mailing Address - Phone:203-500-6152
Mailing Address - Fax:
Practice Address - Street 1:10 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3509
Practice Address - Country:US
Practice Address - Phone:203-500-6152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health