Provider Demographics
NPI:1386984417
Name:GLASTONBURY NATUROPATHIC CENTER LLC
Entity type:Organization
Organization Name:GLASTONBURY NATUROPATHIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PULNIK
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:8606-567-4105
Mailing Address - Street 1:18 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2241
Mailing Address - Country:US
Mailing Address - Phone:860-657-4105
Mailing Address - Fax:
Practice Address - Street 1:18 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2241
Practice Address - Country:US
Practice Address - Phone:860-657-4105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000235175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty